Individual
MISS SHIRLEY BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, SCLV
Contact information
Practice address
706 HIGHWAY 82 W, GREENWOOD, MS 38930-5028
(662) 455-0030
(662) 247-1489
Mailing address
PO BOX 573, BELZONI, MS 39038-0573
(662) 455-0030
(662) 247-1489
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT1121
MS
225XL0004X
Low Vision Occupational Therapist
Primary
OT1121
MS
225XN1300X
Neurorehabilitation Occupational Therapist
OT1121
MS
Other
Enumeration date
03/14/2018
Last updated
10/09/2022
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