Organization
THERAPEUTIC EXPREXXIONS REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NOLA JEAN RAYSON-LOCKE O.T. (CEO)
(662) 621-1701
Entity
Organization
Contact information
Practice address
122 DESOTO AVE, SUITE 109, CLARKSDALE, MS 38614-4420
(662) 621-1701
(662) 621-1702
Mailing address
122 DESOTO AVE, SUITE 109, CLARKSDALE, MS 38614-4420
(662) 621-1701
(662) 621-1702
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0686
OCCUPATIONAL THERAPIST
MS
Enumeration date
05/01/2007
Last updated
08/22/2020
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