Individual
MELANIE L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L, CHT
Contact information
Practice address
300 NE MISSOURI RD, LEES SUMMIT, MO 64086-4714
(816) 836-2500
(816) 836-2525
Mailing address
300 NE MISSOURI RD, LEES SUMMIT, MO 64086-4714
(816) 836-2500
(816) 836-2525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-02390
KS
225XH1200X
Hand Occupational Therapist
Primary
2008014106
MO
Other
Enumeration date
10/10/2007
Last updated
09/17/2014
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