Individual
VANESSA LOUISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1348 GRIFFIN MILL RD, EASLEY, SC 29640-8885
(864) 397-1000
(864) 855-8159
Mailing address
316 WALDEN CREEK WAY, GREENVILLE, SC 29615-6713
(334) 707-6998
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5609
SC
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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