Individual
ALICIA WINDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1392
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1392
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2456
MS
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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