Individual
MS. LYNNE W. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1661 PARK RIDGE DR, CAPABLE KIDS, CHASKA, MN 55318-2841
(952) 403-3987
(952) 403-3979
Mailing address
585 LIBERTY HEIGHTS DR, CHASKA, MN 55318-1673
(952) 448-4482
(952) 403-3979
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100096
MN
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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