NPI 1083975320

Kaneisha Ingram, COTA

Practitioner Occupational Therapy Assistant Jackson, MS

Practice location

Address: 1873 Longwood Dr, Jackson, MS 39212-2509
Phone: (601) 966-2418

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence TA2678 (MS)

Other Occupational Therapy Assistant providers in Mississippi →

Registry record

NPI: 1083975320
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jun 2012
Record last updated: 4 Jun 2012

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.