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Individual

MRS. KATIE MOUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSOTR/L

Contact information

Practice address
193 SAM LISENBY RD, OZARK, AL 36360
(334) 445-6336
Mailing address
21 COUNTY ROAD 739, ENTERPRISE, AL 36330-6829
(908) 872-7113

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3157
NM
225X00000X
Occupational Therapist
Primary
4902
AL

Other

Enumeration date
12/26/2014
Last updated
01/23/2019
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