Individual
ONA IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
105 MUNICH DR, MADISON, MS 39110
(601) 941-1192
Mailing address
105 MUNICH DR, MADISON, MS 39110-9082
(601) 941-1192
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2584
MS
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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