Individual
MAYA ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
801 N 11TH ST, SAINT LOUIS, MO 63101-1015
(615) 031-4331
Mailing address
5119 JAMIESON AVE # 1F, SAINT LOUIS, MO 63109-3031
(636) 293-0483
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2022045861
MO
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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