Individual
DORA CARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
746 E FIFTEENTH ST, YAZOO CITY, MS 39194-2706
(662) 746-4032
(662) 746-0967
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-3205
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1874
MS
Other
Enumeration date
09/28/2016
Last updated
03/15/2018
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