Individual
HEATHER NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1000 ROSEWOOD LN APT A1, HALEYVILLE, AL 35565-8807
(727) 877-9280
Mailing address
1000 ROSEWOOD LN APT A1, HALEYVILLE, AL 35565-8807
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6854
AL
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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