Individual
MRS. STACI SLAYTON HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1500 E WOODROW WILSON AVE # 117, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
1500 E WOODROW WILSON AVE # 117, JACKSON, MS 39216-5116
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2022
MS
Other
Enumeration date
02/23/2009
Last updated
08/28/2014
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