Individual
AUTUMN B TAMOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
116 MARKETRIDGE DR, RIDGELAND, MS 39157-6009
(601) 345-1784
Mailing address
1229 POPLAR BLVD, JACKSON, MS 39202-2110
(601) 551-5612
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT-4071
MS
225XP0200X
Pediatric Occupational Therapist
Primary
OT4071
MS
Other
Enumeration date
07/25/2023
Last updated
06/26/2025
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