Individual
DANIEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4208 GLENNS PASS, WINTER HAVEN, FL 33884-2443
(706) 699-2894
Mailing address
4208 GLENNS PASS, WINTER HAVEN, FL 33884-2443
(706) 699-2894
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2008034752
MO
224Z00000X
Occupational Therapy Assistant
Primary
OTA18819
FL
Other
Enumeration date
02/15/2016
Last updated
09/27/2022
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