Individual
MRS. KAYE B CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL CHT
Contact information
Practice address
1743 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6723
(662) 680-5216
(662) 680-5217
Mailing address
1743 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6723
(662) 680-5216
(662) 680-5217
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OTO912
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09788312
—
MS
Enumeration date
05/03/2006
Last updated
02/14/2019
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