Individual
STEPHANIE MAGGIO KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
711 AVIGON DR, RIDGELAND, MS 39157
(601) 605-6777
Mailing address
8 SUMMERFIELD PL, NATCHEZ, MS 39120-5042
(601) 597-1655
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA0322
MS
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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