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1912288200
KELLY LEANN MILLICAN
RIDGELAND, MS
NPI
1912288200
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MS OT2392)
Enumeration Date
2011-08-31
Last Update Date
2011-08-31
Business Address
-- KELLY LEANN MILLICAN
711 AVIGNON DR
RIDGELAND, MS 39157-5120
Phone number: 601-605-6777
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Mailing Address
-- KELLY LEANN MILLICAN
711 AVIGNON DR
RIDGELAND, MS 39157-5120
Phone number: 601-605-6777
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