Individual
MRS. LORRAINE M STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4500 I 55 N, SUITE 291, HIGHLAND VILLAGE, JACKSON, MS 39211-5930
(601) 362-0859
(601) 362-0870
Mailing address
4500 I 55 N, SUITE 291, HIGHLAND VILLAGE, JACKSON, MS 39211-5930
(601) 362-0859
(601) 362-0870
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0074
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05423701
—
MS
Enumeration date
08/26/2009
Last updated
08/26/2009
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