Provider Demographics
NPI:1689920126
Name:NEAL, SHALA D (OT)
Entity Type:Individual
Prefix:
First Name:SHALA
Middle Name:D
Last Name:NEAL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 RIVER POINTE DR APT 11
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6953
Mailing Address - Country:US
Mailing Address - Phone:870-347-6433
Mailing Address - Fax:
Practice Address - Street 1:821 E PARK ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:AR
Practice Address - Zip Code:72024-9024
Practice Address - Country:US
Practice Address - Phone:870-552-7110
Practice Address - Fax:870-552-7115
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist