Mccoy, Kelly Marie

Mccoy, Kelly Marie is an individual health care provider with primary practice located at 15476 Dedeaux Rd. Suite B, Gulfport MS 39503. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation, which is considered as her primary health care specialty. Mccoy, Kelly Marie can be contacted via phone (228) 679-3001.

Contact Information

Primary practice address
15476 Dedeaux Rd. Suite B Gulfport MS 39503
Phone: (228) 679-3001
Fax: (228) 679-3039
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation 225XP0019X OT3034 Mississippi

Profile Details

NPI number 1700858826
LBN Legal business name Mccoy, Kelly Marie
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Dec 7th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700858826 NPPES
Nevada MEDICAID 1700858826

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