Whalio Doctors

NPI 1073639688

Liesa J Allen, COTA

Practitioner Occupational Therapy Assistant Ridgeland, MS

Practice location

Address
711 Avignon Dr, Ridgeland, MS 39157-5120
Phone
(601) 605-6777
Fax
(800) 517-6935
Mailing address
4501 Highway 39 N APT 13b, Meridian, MS 39301-1073

Registered specialties

Occupational Therapy Assistant Primary
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence TA1993 (MS)

Registry record

NPI
1073639688
Entity type
Individual
Sex (as registered)
Female
NPI issued
22 Mar 2007
Record last updated
8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.