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General NPI Number Information
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NPI Number | 1164640512
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Entity Type | Individual
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Provider Name | ANGELA R BUSBEE OT
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2210 MILL STREET EXT # B
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City | LUCEDALE
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State | MS
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Zip | 39452-6064
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Country | US
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Telephone | 601-947-9005
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Fax | 601-947-9007
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Provider Business Mailing Address
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Address Line | 190 BEAUVOIR RD
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City | BILOXI
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State | MS
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Zip | 39531-5004
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Country | US
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Telephone | 228-388-5714
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Fax | 228-388-0017
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT2067
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License Number State | MS
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