Emilia Blackwell, OT

Individual provider Active NPI Occupational Therapist · Pascagoula, MS

NPI 1831643345 · NPPES record last updated Mar 5, 2024

Key facts

NPI
1831643345
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT3255 (MS)
Practice address
921 Columbus Dr
Pascagoula, MS 39567-6481
Phone
(228) 990-0576
NPI assigned
Aug 12, 2016
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3255 MS Yes

Addresses

Primary practice location

921 Columbus Dr
Pascagoula, MS 39567-6481

Mailing address

921 Columbus Dr
Pascagoula, MS 39567-6481
Phone (228) 990-0576

Other providers in Pascagoula, MS

All providers in Pascagoula, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.