Individual
MS. CYNTHIA ANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
181 HIGHWAY A, DUNNEGAN, MO 65640-9670
(417) 399-3021
Mailing address
181 HIGHWAY A, DUNNEGAN, MO 65640-9670
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2003014790
MO
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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