Individual
JESSICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
228 POINTER TRL W, VAN BUREN, AR 72956-2266
(479) 474-5276
Mailing address
228 POINTER TRL W, VAN BUREN, AR 72956-2266
(479) 474-5276
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2430
AR
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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