Individual
COURTNEY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
868 MULBERRY ST, VAIDEN, MS 39176-5385
(662) 728-6234
Mailing address
2844 TRACELAND DR, TUPELO, MS 38801-4200
(662) 680-3148
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2473
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2473
OT LICENSE MISSISSIPPI
MS
Enumeration date
11/21/2017
Last updated
11/21/2017
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