Individual
ALYS MINCKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1901A MISSION 66, VICKSBURG, MS 39180-3711
(601) 638-4076
(601) 883-2232
Mailing address
1901A MISSION 66, VICKSBURG, MS 39180-3711
(601) 638-4076
(601) 883-2232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1603
MS
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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