Individual
MRS. TARAH AURELIA MANNERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, MS
Contact information
Practice address
731 AVIGNON DR STE 4, RIDGELAND, MS 39157
(601) 300-2624
(601) 510-3512
Mailing address
6208 FERNCREEK DR, JACKSON, MS 39211-2003
(601) 259-8517
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
015655
NY
225X00000X
Occupational Therapist
Primary
OT1714
MS
225X00000X
Occupational Therapist
—
NJ
Other
Enumeration date
03/30/2009
Last updated
07/31/2018
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