Kathryn Anderson, OT

Individual provider Active NPI Occupational Therapist · Ridgeland, MS

NPI 1275937492 · NPPES record last updated Oct 17, 2014

Key facts

NPI
1275937492
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT2538 (MS)
Practice address
711 Avignon Dr
Ridgeland, MS 39157-5120
Phone
(601) 605-6777
Fax
(601) 607-1415
NPI assigned
Oct 17, 2014
Sex
Female
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

LicenseStateTypeSpecialty
OT2538MSMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT2538 MS Yes

Addresses

Primary practice location

711 Avignon Dr
Ridgeland, MS 39157-5120

Mailing address

711 Avignon Dr
Ridgeland, MS 39157-5120
Phone (601) 605-6777

Other providers in Ridgeland, MS

All providers in Ridgeland, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.