Individual
MISS NANCY C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
21 WATERVILLE RD, ALLSTAR, AVON, CT 06001-2097
(860) 678-9755
Mailing address
21 WATERVILLE RD, ALLSTAR, AVON, CT 06001-2097
(860) 678-9755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003024
CT
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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