| Imani Community Outreach Center | |
|
301 E Jefferson St, Kosciusko, MS 39090-3719 | |
| (662) 289-7676 | |
| Not Available |
| Full Name | Imani Community Outreach Center |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 301 E Jefferson St, Kosciusko, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477829182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Imani Community Outreach Center 301 E Jefferson St, Kosciusko, MS 39090-3719 Ph: (662) 289-7676 | Imani Community Outreach Center 301 E Jefferson St, Kosciusko, MS 39090-3719 Ph: (662) 289-7676 |
Sophie Champagne Black, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 310 Autumn Ridge Dr, Kosciusko, MS 39090 Phone: 662-289-3499 | |
Sarah Putt, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 130 Parkway Plz, Kosciusko, MS 39090 Phone: 662-289-3588 Fax: 662-289-3533 | |
Imani Finley, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 310 Autumn Ridge Dr, Kosciusko, MS 39090 Phone: 662-739-6162 Fax: 662-739-6163 | |
Mrs. Tanya L Steen, O.T. Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 130 Parkway Plaza, Kosciusko, MS 39090 Phone: 662-289-3488 Fax: 662-289-3433 | |
Mylissa Hodges, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 310 Autumn Ridge Dr, Kosciusko, MS 39090 Phone: 662-289-3499 | |
Mrs. Dorothy Michele Fulgham, O.T. Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 130 Parkway Plz, Kosciusko, MS 39090 Phone: 662-289-3588 Fax: 662-289-2486 |