Individual
LEONARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1350 E LOOKOUT DR, RICHARDSON, TX 75082-4106
(972) 220-2000
Mailing address
3577 N BELTLINE RD #209, IRVING, TX 75062
(972) 220-2000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
366125
TX
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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