Individual
DIANA MARY HACKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 COOPER ST, JACKSON, MI 49202-3398
(517) 796-1600
Mailing address
900 COOPER ST, JACKSON, MI 49202-3398
(517) 796-1600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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