Individual
MARY SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
207 W JACKSON ST, RIDGELAND, MS 39157-2355
(601) 427-5703
Mailing address
207 W JACKSON ST, RIDGELAND, MS 39157-2355
(601) 427-5703
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3210
MS
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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