Individual
BRENDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2300 DULANEY VALLEY RD, TIMONIUM, MD 21093-2700
(410) 252-4500
Mailing address
5414 DAYWALT AVE, BALTIMORE, MD 21206-4435
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
03967
MD
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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