Magnolia Occupational & Physical Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

MAGNOLIA OCCUPATIONAL & PHYSICAL THERAPY, LLC

Practice address

2525 Highway 90 Ste 11
Gautier, MS 39553-5247

Phone

(228) 313-5305

NPI assigned

Jun 25, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frances Palazzolo, OTR/L

Title

Owner/Manager

Phone

(228) 471-5205

Specialties & licenses 2

Addresses

Other names 1

• Magnolia Occupational & Physical Therapy Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1902476625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 HIGHWAY 90 STE 11",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535247",
            "telephone_number": "228-417-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 HIGHWAY 90 STE 11",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535247",
            "telephone_number": "228-313-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA OCCUPATIONAL & PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2022-01-26",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "PALAZZOLO",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "228-471-5205",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Occupational & Physical Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Magnolia Occupational & Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Lee Luce, CRNA
• Leslie Eaton Lyons
• Channon Rebecca Lytton, E.DD.
• Kimberlie La'Tasha Mabry, FNP-C
• Ebbie Larhonda Maddox, LMSW
• Loggan Malone Weihe, DMD
• Ellen L.H. Malone, LISW, LCSW, ACSW
• Amber Nicole Mapp, BA
• David Wesley Marks, BS PSYCHOLOGY
• Bessie L Marshall, BS

• Occupational Therapist in Gautier, MS
• Providers in Gautier, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.