IndividualActive
Jacqueline White-Ivey, COTA
NPI 1629499983 · Occupational Therapy Assistant · Summit, MS
Provider details
- NPI number
- 1629499983
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- TAO564 (MS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4109 Highway 98 W
Summit, MS 39666-9132
Phone: (601) 276-3900
Approximate (ZIP-level) locationGet directions
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Registry dates
- Enumerated
- 2014-01-03
- Last updated
- 2014-01-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.