Individual
STEPHANIE A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
151 SKYLINE VISTA DR, FRONT ROYAL, VA 22630-8219
(540) 631-0366
Mailing address
1000 OPEQUON AVE, WINCHESTER, VA 22601-5130
(540) 664-7622
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007678
VA
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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