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Individual

CRYSTAL LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
7805 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4741
(228) 324-6876
Mailing address
5365 BRADLEY LN, SOUTHAVEN, MS 38671-6946
(228) 324-6876

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2816
MS

Other

Enumeration date
04/04/2015
Last updated
04/04/2015
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