Individual
MS. JENNIFER L. SMYLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
120 VETERANS DRIVE, VA STATE HOME / OXFORD, OXFORD, MS 38655
(601) 206-9195
(601) 957-8391
Mailing address
P.O. BOX 315, RIDGELAND, MS 39158
(601) 206-9195
(601) 957-8391
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2725
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014160
—
MS
Enumeration date
10/16/2012
Last updated
10/16/2012
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