Individual
MISS ERIN VICTORIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
230 MAIN ST, NORWAY, ME 04268-5921
(508) 341-0601
(207) 743-7063
Mailing address
59 SHORE RD, OTISFIELD, ME 04270-6442
(508) 341-0601
(207) 743-7063
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12164
FL
225XP0200X
Pediatric Occupational Therapist
6944
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891136300
—
FL
Enumeration date
08/20/2006
Last updated
12/16/2010
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