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NPI 1548128390

NPI 1548128390 : CHLOE ALAINA LIDDON OT : JACKSON, MS

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General NPI Number Information
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    NPI Number           |    1548128390
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    Entity Type          |    Individual 
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    Provider Name        |    CHLOE ALAINA LIDDON OT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/12/2026
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    Last Update Date     |    01/12/2026
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Provider Practice Location Address
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    Address Line         |    5411 I 55 N 
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    City                 |    JACKSON
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    State                |    MS
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    Zip                  |    39206-3616
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    Country              |    US
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    Telephone            |    601-940-5906
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    Fax                  |    601-510-9012
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Provider Business Mailing Address
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    Address Line         |    PO BOX 75 
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    City                 |    MADISON
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    State                |    MS
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    Zip                  |    39130-0075
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    Country              |    US
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    Telephone            |    769-216-3288
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    Fax                  |    601-510-9012
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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       |    4254
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    License Number State |    MS
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