Provider Demographics
NPI:1952064917
Name:LEDBETTER, ANDREE NICOLE MORGAN (OT)
Entity Type:Individual
Prefix:
First Name:ANDREE
Middle Name:NICOLE MORGAN
Last Name:LEDBETTER
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 1:1000 MELLON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6143
Mailing Address - Country:US
Mailing Address - Phone:501-627-4781
Mailing Address - Fax:
Practice Address - Street 1:1000 MELLON ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6143
Practice Address - Country:US
Practice Address - Phone:501-627-4781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3583225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist