Individual
MS. LORENDA DELORIS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8009 HILL N DALE DR, KERNERSVILLE, NC 27284-9853
(336) 624-6519
Mailing address
325 W MOUNTAIN ST, KERNERSVILLE, NC 27285-0807
(336) 624-6519
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5397
NC
Other
Enumeration date
12/24/2008
Last updated
02/01/2013
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