Individual
JAYLA RUSCHEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1129 CHEW FORKS RD, BENTON, MS 39039-9018
(662) 207-1322
Mailing address
1129 CHEW FORKS RD, BENTON, MS 39039-9018
(662) 207-1322
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3352
MS
Other
Enumeration date
12/18/2017
Last updated
01/11/2022
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