Jennifer Ros Craig, OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Madison, MS

NPI 1003589896 · NPPES record last updated Jul 27, 2021

Key facts

NPI
1003589896
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
OT1361 (MS)
Practice address
7712 Old Canton Rd
Madison, MS 39110-9299
Phone
(601) 427-5775
Fax
(601) 206-0668
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT1361MSMDPediatric Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT1361 MS Yes

Addresses

Primary practice location

7712 Old Canton Rd
Madison, MS 39110-9299

Mailing address

5110 Canton Heights Dr
Jackson, MS 39211-4515
Phone (601) 750-4493

Other providers in Madison, MS

All providers in Madison, MS · Pediatric Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.