Tyler Beall, COTA
Individual provider Active NPI Occupational Therapy Assistant · Wiggins, MS
NPI 1003634098 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1003634098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA-3791 (MS)
- Practice address
- 14 C E Morrison LN
Wiggins, MS 39577-8949 - Phone
- (601) 325-6390
- NPI assigned
- Sep 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA-3791 | MS | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA-3791 | MS | Yes |
Addresses
Primary practice location
14 C E Morrison LN
Wiggins, MS 39577-8949
Mailing address
14 C E Morrison LN
Wiggins, MS 39577-8949
Phone (601) 325-6390
Other providers in Wiggins, MS
- Audesi Home Care LLC
- Azalea Gardens Nursing Center, LLC
- Virginia Barham
- Batson Physical Therapy, Inc.
- Tracey Duncan Batson
- William Walton Beazley
- Heather N. Bond
- Wendalyn Bostic
- Emily Anne Burger
- Deepinder S. Burn
All providers in Wiggins, MS · Occupational Therapy Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.