Individual
KENDALL JO LACKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1755 WITTINGTON PL STE 175, DALLAS, TX 75234-1905
(214) 442-4210
Mailing address
69 CALVARY RD, CHARLEROI, PA 15022-1128
(724) 678-4814
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00119-007728
VA
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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