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General NPI Number Information
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NPI Number | 1881020477
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS THERAPY OF OXFORD, PLLC
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 21006 WILLS TRCE
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City | OXFORD
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State | MS
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Zip | 38655-5186
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Country | US
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Telephone | 662-471-8848
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Fax |
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Provider Business Mailing Address
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Address Line | 21006 WILLS TRCE
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City | OXFORD
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State | MS
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Zip | 38655-5186
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Country | US
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Telephone | 662-471-8848
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER BARTHOLOMEW
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Credential | OT
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Telephone | 662-471-8848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT0375
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License Number State | MS
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