Individual
JENNIFER REISS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3932 N 10TH AVE, PENSACOLA, FL 32503-2807
(850) 434-7755
Mailing address
1673 KINSALE DR, CANTONMENT, FL 32533-8974
(850) 937-4719
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8640
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8857318
—
FL
Enumeration date
08/16/2006
Last updated
07/09/2007
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