Individual
KERRIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
352 WAYNE PARDUE RD, LUMBERTON, MS 39455-8867
(601) 408-9785
Mailing address
352 WAYNE PARDUE RD, LUMBERTON, MS 39455-8867
(601) 408-9785
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2884
MS
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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