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Individual

TAYLOR CRAWFORD LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
7712 OLD CANTON RD STE B, MADISON, MS 39110-9299
(601) 692-8129
Mailing address
11295-A CENTERHILL MARTIN RD, COLLINSVILLE, MS 39325
(601) 737-4612

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3505
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT3505
PRIVATE PRACTICE
MS
Enumeration date
06/20/2018
Last updated
06/20/2018
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