Individual
DIANE JANE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
239 PLEASANT ST, CONCORD, NH 03301-7504
(603) 224-6561
Mailing address
106 PENACOOK RD, CONTOOCOOK, NH 03229-3016
(603) 746-2439
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1133
NH
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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