Healthcare Provider Details

I. General information

NPI: 1093201329
Provider Name (Legal Business Name): KAYLA RIGSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10331 PATRICK DR
GULFPORT MS
39503-4093
US

IV. Provider business mailing address

10331 PATRICK DR
GULFPORT MS
39503-4093
US

V. Phone/Fax

Practice location:
  • Phone: 228-574-5225
  • Fax:
Mailing address:
  • Phone: 228-574-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3328
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: