Individual
MARIAH KAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
CREATIVE KIDS THERAPY, JONESBORO, AR 72401
(870) 336-0220
Mailing address
4004 GABRIEL CT, JONESBORO, AR 72405-8676
(573) 727-4808
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4493
AR
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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