Individual
TAKISHA KAYON SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5130 WEDGEWOOD DR, OLIVE BRANCH, MS 38654-6616
(912) 308-8143
Mailing address
4744 WE ROSS PKWY APT 50-201, SOUTHAVEN, MS 38671-7003
(912) 308-8143
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3722
MS
Other
Enumeration date
11/18/2019
Last updated
08/09/2022
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