Individual
MRS. CONNIE MCCARRA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-6090
Mailing address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-6090
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0368
MS
Other
Enumeration date
11/05/2013
Last updated
09/15/2015
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