Individual
MRS. CAITLYN BANKSTON HUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
13 NORTHTOWN DR STE 110, JACKSON, MS 39211-3047
(601) 206-9195
Mailing address
302 GREENSBORO DR, BRANDON, MS 39047-4700
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-3552
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3552
PRIVATE INSURANCE
MS
Enumeration date
03/23/2021
Last updated
03/23/2021
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