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Individual

MRS. MALY DY JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3605 COLLEGE AVE, CONWAY, AR 72034-7377
(501) 327-2235
(501) 327-1601
Mailing address
15 HOGAN DR, MAUMELLE, AR 72113-6410
(501) 590-3334
(501) 327-1601

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR463
AR

Other

Enumeration date
02/27/2008
Last updated
02/27/2008
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