Individual
MRS. KARLY MITCHELL SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
311 N MAIN ST, PICAYUNE, MS 39466-3313
(601) 799-4065
(601) 620-4117
Mailing address
75 DUPONT HARTS CHAPEL RD, POPLARVILLE, MS 39470-4014
(601) 463-0993
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA3243
MS
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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