Individual
MRS. MEAGEN M MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
950 E COUNTY LINE RD, STE E, RIDGELAND, MS 39157-1928
(601) 853-9147
(601) 898-4761
Mailing address
199 BROOKMOORE DRIVE, COLUMBUS, MS 39705
(662) 327-6705
(662) 327-6760
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1419
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07685379
—
MS
Enumeration date
04/03/2006
Last updated
06/15/2017
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