Individual
STEPHANIE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7213 S SIWELL RD, BYRAM, MS 39272-9776
(601) 346-9191
(601) 346-3044
Mailing address
7213 S SIWELL RD, BYRAM, MS 39272-9776
(601) 346-9191
(601) 346-3044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT2694
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2694
OCCUPATIONAL THERAPIST
MS
Enumeration date
04/30/2014
Last updated
04/30/2014
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