Individual
MRS. MICHELLE W. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1826 VETERANS BLVD, DUBLIN, GA 31021-3620
(478) 272-1210
Mailing address
1013 RIVERBURCH PKWY, SUITE 4, DALTON, GA 30721-8887
(866) 261-8090
(706) 226-7869
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA000528
GA
225X00000X
Occupational Therapist
Primary
OT005232
GA
Other
Enumeration date
04/15/2009
Last updated
04/19/2021
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