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Individual

MRS. CANDICE SHERYL LOCKLEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
12303 HIGHWAY 49, GULFPORT, MS 39503-2780
(228) 832-6221
Mailing address
10678 JAKE BELL RD, GULFPORT, MS 39503-8112
(228) 861-9910
(228) 832-6221

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2391
MS

Other

Enumeration date
06/11/2010
Last updated
06/11/2010
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