Organization
CHILDREN'S THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA O'NEILL SPARKS OTRL (OWNER)
(662) 279-2523
Entity
Organization
Contact information
Practice address
164B COUNTY ROAD 363, IUKA, MS 38852-7057
(662) 279-2523
Mailing address
164B COUNTY ROAD 363, IUKA, MS 38852-7057
(662) 279-2523
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1721
MS
Other
Enumeration date
11/21/2006
Last updated
02/04/2013
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