Individual
LESLIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1393 N BALDWIN AVE, MARION, IN 46952-1913
(765) 660-7900
Mailing address
6277 N 900 W 27, CONVERSE, IN 46919-9376
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31003280A
IN
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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