IndividualActive
Connie Fowlkes, COTA/L
NPI 1386005478 · Occupational Therapy Assistant · Columbus, MS
Provider details
- NPI number
- 1386005478
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- No
- License
- TA3116 (MS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
310 Emerald Dr
Columbus, MS 39702-5526
Phone: (662) 244-8823
Approximate (ZIP-level) locationGet directions
Mailing address
310 Emerald Dr
Columbus, MS 39702-5526
Registry dates
- Enumerated
- 2016-03-16
- Last updated
- 2016-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.