Individual
CHARLIE ANNE BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
(601) 276-3900
Mailing address
2725 HIGHWAY 550 NW, BROOKHAVEN, MS 39601-8537
(601) 754-3331
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2258
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2925
—
MS
Enumeration date
10/12/2012
Last updated
02/02/2022
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