Individual
TYLER BEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
14 C E MORRISON LN, WIGGINS, MS 39577-8949
(601) 325-6390
Mailing address
14 C E MORRISON LN, WIGGINS, MS 39577-8949
(601) 325-6390
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-3791
MS
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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