Individual
MS. LYDIA S. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
23 MASON ST, LAUREL, MS 39440-4437
(601) 399-0534
Mailing address
11 CANEBRAKE BLVD, HATTIESBURG, MS 39402-8703
(601) 268-1487
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1537
MS
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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