Individual
MS. SHARON KAY BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1308 BARLOW DR, UTICA, MS 39175-9423
(601) 624-2043
(601) 885-2060
Mailing address
PO BOX 91, UTICA, MS 39175-0091
(601) 624-2043
(601) 885-2060
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 0346
MS
261QD1600X
Developmental Disabilities Clinic/Center
OT0346
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118814
—
MS
Enumeration date
10/20/2006
Last updated
11/04/2008
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