Individual
MRS. TAMEKIA POUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
23804 EAGLE PASS RD, APT 2, FORT RILEY, KS 66442-2669
(601) 543-5370
Mailing address
23804 EAGLE PASS RD, APT 2, FORT RILEY, KS 66442-2669
(601) 543-5370
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1999
MS
225X00000X
Occupational Therapist
T-04056
KS
Other
Enumeration date
06/20/2011
Last updated
02/02/2015
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