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EBONY LAPORSCHE FEARS ASHMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1227 PIN OAK DR, APT M4, FLOWOOD, MS 39232-9702
(662) 295-1932
Mailing address
1227 PIN OAK DR, APT M4, FLOWOOD, MS 39232-9702
(662) 295-1932

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3089
MS

Other

Enumeration date
05/25/2016
Last updated
05/25/2016
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