Individual
KATIE MARIE WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 JOHN R JUNKIN DR, NATCHEZ, MS 39120-4709
(610) 925-4089
Mailing address
600 S BROAD ST, KENNETT SQUARE, PA 19348-3346
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA.200145
LA
224Z00000X
Occupational Therapy Assistant
Primary
TA2665
MS
Other
Enumeration date
04/09/2012
Last updated
04/09/2012
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