Individual
JEN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 MARYLAND AVE, MCCOMB, MS 39648-3926
(601) 250-4815
Mailing address
184 NORTHSHORE WAY, MADISON, MS 39110-7177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0513
MS
Other
Enumeration date
02/18/2008
Last updated
02/18/2008
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