| NPI | 1235922758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI HARRELL Occupational Therapist 662-832-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-29 |