Individual
BRIANNA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7010 15TH ST N, SAINT PETERSBURG, FL 33702-5738
(727) 200-4045
Mailing address
13271 OPAL CT, LARGO, FL 33773-1681
(402) 826-0414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23818
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118446200
—
FL
Enumeration date
06/13/2019
Last updated
04/16/2025
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