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NPI Code Detail

MEDICARE: MARY KATHY WORTHY OTR/L

MEDICARE:   MARY KATHY WORTHY  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT2138MS

General Provider Information

NPI Number : 1548453632
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KATHY WORTHY OTR/L
Provider Business Mailing Address
First Line : 13 NORTHTOWN DR
Second Line : SUITE 110
City : JACKSON
State : MS
Zip : 39211-3047
Country : US
Telephone Number : 601-206-9195
Fax Number : 601-957-8391
Provider Business Practice Location Address
First Line : 13 NORTHTOWN DR
Second Line : SUITE 110
City : JACKSON
State : MS
Zip : 39211-3047
Country : US
Telephone Number : 601-206-9195
Fax Number : 601-957-8391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 08/22/2007

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Directions to “ MARY KATHY WORTHY OTR/L” Practice Location

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