Individual
RACQUEL GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 SILVER LK, PEARL, MS 39208-5079
(601) 941-8323
Mailing address
224 SILVER LK, PEARL, MS 39208-5079
(601) 941-8323
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2366
MS
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
OTA-2366
MS
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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