Individual
EMMA MIKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1263 ROAD 931, TUPELO, MS 38804-8260
(205) 412-6970
Mailing address
1263 ROAD 931, TUPELO, MS 38804-8260
(205) 412-6970
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0756
MS
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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