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Contact Information

STACEY S VOLLENWEIDER, OTR/L
311 N MAIN ST
PICAYUNE, MS39466-3313
 Phone: 601-799-4065
 Fax: 601-620-4117
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for STACEY S VOLLENWEIDER · (Female)

NPI Number 1417245648
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 07/21/2011
Last updated 12/31/2014 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # OT1249
  • MS Medicaid 06524202
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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