Individual
SHELIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
06/24/2006
Last updated
05/15/2013
Update your record
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