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NPI 1346439684

NPI 1346439684 : ROSA M VERNEUILLE O.T. : RICHLAND, MS

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General NPI Number Information
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    NPI Number           |    1346439684
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    Entity Type          |    Individual 
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    Provider Name        |    ROSA M VERNEUILLE O.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/23/2007
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    Last Update Date     |    12/02/2015
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Provider Practice Location Address
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    Address Line         |    1201 HIGHWAY 49 S SUITE 2
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    City                 |    RICHLAND
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    State                |    MS
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    Zip                  |    39218-9425
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    Country              |    US
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    Telephone            |    769-233-8844
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    Fax                  |    769-251-1825
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Provider Business Mailing Address
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    Address Line         |    2416 HIGHWAY 45 N 
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    City                 |    COLUMBUS
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    State                |    MS
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    Zip                  |    39705-1320
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    Country              |    US
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    Telephone            |    662-327-6705
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    Fax                  |    662-327-6760
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    OT1050
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    License Number State |    MS
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