Individual
KATHERINE NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6450 S BOSTON ST, GREENWOOD VILLAGE, CO 80111-5336
(303) 224-9455
Mailing address
8769 CREEKSIDE WAY APT 836, HIGHLANDS RANCH, CO 80129-2208
(336) 944-3040
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0001702
CO
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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