Individual
ALEXIS MALAINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
1800 NATIONS DR, SUITE 208, GURNEE, IL 60031-9168
(847) 477-9034
Mailing address
820 KINGSTON AVE, RACINE, WI 53402-4049
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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