Provider Demographics
NPI:1265708945
Name:ZEINER, TRACEY LEIGH (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:LEIGH
Last Name:ZEINER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9818 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:HACKETT
Mailing Address - State:AR
Mailing Address - Zip Code:72937-4027
Mailing Address - Country:US
Mailing Address - Phone:501-350-9358
Mailing Address - Fax:
Practice Address - Street 1:7006 CHAD COLLEY BLVD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-6024
Practice Address - Country:US
Practice Address - Phone:479-401-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR526225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130421721Medicaid