Individual
MS. LAUREN MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
4175 STONERIDGE LN, DUBLIN, OH 43017-2080
(502) 724-2604
Mailing address
912 AUDUBON PKWY, LOUISVILLE, KY 40213-1366
(502) 724-2604
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT009241
OH
Other
Enumeration date
11/18/2008
Last updated
09/30/2016
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