Individual
BRANDON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
(747) 210-3311
Mailing address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT22837
CA
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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