Individual
TIFFANY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
214 S WASHINGTON ST, STARKVILLE, MS 39759-3230
(662) 323-2989
Mailing address
PO BOX 1282, STARKVILLE, MS 39760-1282
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3934
MS
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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