Provider Demographics
NPI:1285799189
Name:TINNEY, LAURA LEIGH (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEIGH
Last Name:TINNEY
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEIGH
Other - Last Name:HUTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 MALAGA WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-2621
Mailing Address - Country:US
Mailing Address - Phone:501-940-1103
Mailing Address - Fax:
Practice Address - Street 1:155 CARPENTER DAM ROAD
Practice Address - Street 2:SUITE I
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901
Practice Address - Country:US
Practice Address - Phone:501-940-1103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2006225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y981OtherBLUE CROSS BLUE SHIELD
AR161069721Medicaid