Provider Demographics
NPI:1619133485
Name:HARBOUR, CHERI (MS,OTR/L, SCLV)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:
Last Name:HARBOUR
Suffix:
Gender:F
Credentials:MS,OTR/L, SCLV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 BRUNSON DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4947
Mailing Address - Country:US
Mailing Address - Phone:662-377-3340
Mailing Address - Fax:662-377-3349
Practice Address - Street 1:606 BRUNSON DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4947
Practice Address - Country:US
Practice Address - Phone:662-377-3340
Practice Address - Fax:662-377-3349
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT0136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist