Individual
MARIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
98 STARR FARM RD, BURLINGTON, VT 05408-1323
(802) 658-6717
Mailing address
98 STARR FARM RD, BURLINGTON, VT 05408-1323
(802) 658-6717
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072-0000384
VT
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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