Individual
MS. OLIVIA LIPSCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
124 BAYOU RD, GREENVILLE, MS 38701-7725
(601) 906-3902
Mailing address
124 BAYOU RD, GREENVILLE, MS 38701-7725
(601) 906-3902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
O-T0914
AR
225X00000X
Occupational Therapist
Primary
OT2398
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177891721
—
AR
Enumeration date
08/11/2009
Last updated
03/04/2019
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