Individual
HEATHER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5313 DECKER DR, BAYTOWN, TX 77520-1413
(281) 838-4477
Mailing address
5313 DECKER DR, BAYTOWN, TX 77520-1413
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117917
OT LICENSE
TX
Enumeration date
05/26/2020
Last updated
05/26/2020
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