Individual
REBECCA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3219
MS
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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