Individual
MRS. CONSTANCE HOPE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1036 WEST DR, LAUREL, MS 39440-4706
(601) 425-3191
Mailing address
801 JORDAN SUMRALL RD, BUCKATUNNA, MS 39322-9630
(601) 410-0620
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2573
MS
225XG0600X
Gerontology Occupational Therapist
OT2573
MS
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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