Individual
MRS. ANDREA GAIL MANNARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
629 SLADE WOODWARD RD, POPLARVILLE, MS 39470-7157
(228) 363-3116
Mailing address
629 SLADE WOODWARD RD, POPLARVILLE, MS 39470-7157
(228) 363-3116
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2953
MS
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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