Individual
KENYA DELISA WEATHERSPOON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1500 E. WOODROW WILSON DRIVE, C/O OCCUPATIONAL THERAPY 117, JACKSON, MS 39216
(601) 362-4471
(601) 968-3904
Mailing address
1500 E. WOODROW WILSON DRIVE, C/O OCCUPATIONAL THERAPY 117, JACKSON, MS 39216
(601) 362-4471
(601) 968-3904
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0262
MS
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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