Individual
MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10200 RICHMOND AVE, HOUSTON, TX 77042-4140
(832) 585-2645
Mailing address
10200 RICHMOND AVE, HOUSTON, TX 77042-4140
(832) 585-2645
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209120
TX
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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