Mary Camille Powell, OT/L

Individual provider Active NPI Occupational Therapist · Saltillo, MS

NPI 1700923307 · NPPES record last updated Sep 1, 2015

Key facts

NPI
1700923307
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT0669 (MS)
Practice address
2319 Highway 145
Saltillo, MS 38866-9199
Phone
(662) 869-9970
Fax
(662) 869-9980
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OT0669MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy Occupational Therapist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT0669 MS Yes

Addresses

Primary practice location

2319 Highway 145
Saltillo, MS 38866-9199

Mailing address

2319 Hwy 145
Saltillo, MS 38866
Phone (662) 869-9970

Other identifiers

IdentifierTypeStateIssuer
07857321MedicaidMS

Other providers in Saltillo, MS

All providers in Saltillo, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.