Individual
MRS. SARA C BRADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
311 N MAIN ST, PICAYUNE, MS 39466-3313
(601) 799-4065
(601) 620-4117
Mailing address
20 NEWT MITCHELL RD, PICAYUNE, MS 39466-9224
(601) 916-8329
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2316
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09938061
—
MS
Enumeration date
09/12/2013
Last updated
01/10/2015
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