Individual
DIANE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3727 FRIENDSVILLE RD, WOOSTER, OH 44691-7131
(330) 202-3300
(330) 202-3304
Mailing address
3727 FRIENDSVILLE RD, WOOSTER, OH 44691-7131
(330) 202-3300
(330) 202-3304
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03943
OH
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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