Healthcare Provider Details

I. General information

NPI: 1437968724
Provider Name (Legal Business Name): LAURA KATHERINE TARANTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA KATE TARANTO

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W JACKSON ST STE 1D
RIDGELAND MS
39157-2428
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 601-853-9747
  • Fax:
Mailing address:
  • Phone: 423-238-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-4202
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: