Southern Pediatric Therapy
NPI #1063985885 in Hernando, Mississippi
Provider Information
- NPI Number
- 1063985885
- Entity Type
- Organization
- Organization Name
- Southern Pediatric Therapy
- Primary Specialty
- Occupational Therapist - Pediatrics
- Enumeration Date
- Jan 3, 2019
- Last Updated
- Jan 3, 2019
Practice Location
- Address
- 1772 CARLEE DR
- City
- Hernando
- State
- Mississippi
- ZIP Code
- 38632-8844
- Phone
- (662) 469-2906
Authorized Official
- Name
- JENNIFER PACILEO, OTR/L
- Title
- OWNER
- Phone
- (662) 469-2906
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist - Pediatrics — Pediatrics |
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