Individual
MS. STACI LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2386 CLOWER ST, BLD E, STE 102, SNELLVILLE, GA 30078-6134
(770) 985-9050
(770) 985-9223
Mailing address
2386 CLOWER ST, BLD E, STE 102, SNELLVILLE, GA 30078-6134
(770) 985-9050
(770) 985-9223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003559
GA
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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