Healthcare Provider Details

I. General information

NPI: 1104734557
Provider Name (Legal Business Name): MEGAN ROBBINS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 CONSTITUTION DR
IUKA MS
38852-8605
US

IV. Provider business mailing address

503 CONSTITUTION DR
IUKA MS
38852-8605
US

V. Phone/Fax

Practice location:
  • Phone: 662-424-9500
  • Fax: 662-424-9592
Mailing address:
  • Phone: 662-424-9500
  • Fax: 662-424-9592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-4031
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: