Individual
TARYN DYESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
24 TRYSTAN DR, PETAL, MS 39465-2839
(601) 408-1150
Mailing address
24 TRYSTAN DR, PETAL, MS 39465-2839
(601) 408-1150
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TA2646
MS
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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