Individual
SANDRA RAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6308 PARKWOOD PL, AMARILLO, TX 79119-5003
(806) 433-2211
Mailing address
6308 PARKWOOD PL, AMARILLO, TX 79119-5003
(806) 433-2211
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208284
TX
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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