| Sophie Champagne Black, | |
|
310 Autumn Ridge Dr, Kosciusko, MS 39090-3242 | |
| (662) 289-3499 | |
| Not Available |
| Full Name | Sophie Champagne Black |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 310 Autumn Ridge Dr, Kosciusko, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093920522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT0533 (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Sophie Champagne Black, 4109 Highway 98 W, Summit, MS 39666-9132 Ph: (601) 276-3900 | Sophie Champagne Black, 310 Autumn Ridge Dr, Kosciusko, MS 39090-3242 Ph: (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 | |
Imani Community Outreach Center Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 E Jefferson St, Kosciusko, MS 39090 Phone: 662-289-7676 | |
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 |