Individual
ADA L. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3360 OAKWELL CT, SAN ANTONIO, TX 78218-3061
(210) 826-5348
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200737
TX
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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