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NPI Code Detail

MEDICARE: KATIE OAKS OT

MEDICARE: KATIE OAKS OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT2960MS

General Provider Information

NPI Number : 1184178634
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE OAKS OT
Provider Business Mailing Address
First Line : 1410 W QUITMAN ST
Second Line :
City : IUKA
State : MS
Zip : 38852-1129
Country : US
Telephone Number : 662-423-3422
Fax Number :
Provider Business Practice Location Address
First Line : 1410 W QUITMAN ST
Second Line :
City : IUKA
State : MS
Zip : 38852-1129
Country : US
Telephone Number : 662-423-3422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2016
Last Update Date : 08/12/2016

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Directions to “ KATIE OAKS OT” Practice Location

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