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Individual

MRS. DANICA MONIQUE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHS, OTR/L

Contact information

Practice address
620 TOM HUNTER RD, CHARLOTTE, NC 28213-5511
(704) 900-5513
Mailing address
3418 FROSTMOOR PL, CHARLOTTE, NC 28269-2172
(704) 910-2161

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5610
NC

Other

Enumeration date
03/16/2007
Last updated
01/21/2025
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