Individual
MRS. STEPHANIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3131 TOM AUSTIN HWY, SPRINGFIELD, TN 37172-4801
(615) 382-7979
Mailing address
1004 WELLMOOR CT, NASHVILLE, TN 37209-5026
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000004002
TN
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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