Basic Information
Provider Information
NPI: 1962732495
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHISLER
FirstName: ALLISON
MiddleName: EVERETT
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: EVERETT
OtherFirstName: ALLISON
OtherMiddleName: N
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 8419
Address2:  
City: BILOXI
State: MS
PostalCode: 395358087
CountryCode: US
TelephoneNumber: 2283885714
FaxNumber: 2283880017
Practice Location
Address1: 2541 PASS RD
Address2:  
City: BILOXI
State: MS
PostalCode: 395312106
CountryCode: US
TelephoneNumber: 2288181200
FaxNumber: 2288181213
Other Information
ProviderEnumerationDate: 01/06/2010
LastUpdateDate: 06/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT2387MSY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

ID Information
IDTypeStateIssuerDescription
103321852401MSGROUP NPIOTHER
0763023405MS MEDICAID


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