Individual
KELSEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
860 HIGHWAY 62 E STE 10, MOUNTAIN HOME, AR 72653-3200
(870) 424-2224
(870) 424-0493
Mailing address
860 HIGHWAY 62 E STE 10, MOUNTAIN HOME, AR 72653-3200
(870) 424-2224
(870) 424-0493
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A875
AR
Other
Enumeration date
04/29/2015
Last updated
04/29/2015
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