Individual
JULIE MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
107 BELLA MONTAGNA CIR, LAKEWAY, TX 78734-2648
(512) 598-0714
Mailing address
1101 CAMILLE DR, LONGVIEW, TX 75605-1444
(903) 932-0467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
122600
TX
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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