Miranda Wade, OT
Individual provider Active NPI Occupational Therapist · Water Valley, MS
NPI 1992269500 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1992269500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT3520 (MS)
- Practice address
- 630 S Main St
Water Valley, MS 38965-3468 - Phone
- (662) 473-5947
- NPI assigned
- Jan 28, 2019
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT3520 | MS | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT3520 | MS | Yes |
Addresses
Primary practice location
630 S Main St
Water Valley, MS 38965-3468
Mailing address
711 Avignon Dr
Ridgeland, MS 39157-5120
Phone (601) 605-6777
Other providers in Water Valley, MS
- Ben F Toole
- Turnage Drug Store Inc
- Vicki L Turnage
- Natalie Bryant Turner
- Valley Drugs, Inc.
- Water Valley Dental, PLLC
- Water Valley Medical Clinic LLC
- Water Valley Rural Health Paul Odom MD
- Webb Family Medical Clinic PLLC
- James Craig Webb
All providers in Water Valley, MS · Occupational Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2019. 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.