Andrea Jean Brown, COTA

Individual provider Active NPI Occupational Therapy Assistant · Macon, MS

NPI 1992562904 · NPPES record last updated Mar 5, 2024

Key facts

NPI
1992562904
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA3958 (MS)
Practice address
78 Hospital Rd
Macon, MS 39341-2490
Phone
(662) 295-1127
NPI assigned
Mar 5, 2024
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
OTA3958MSMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA3958 MS Yes

Addresses

Primary practice location

78 Hospital Rd
Macon, MS 39341-2490

Mailing address

977 E Tva Rd
West Point, MS 39773-5284
Phone (662) 295-1127

Other providers in Macon, MS

All providers in Macon, MS · Occupational Therapy Assistant in Mississippi

Sources for this page

Verify at the official NPI Registry.