Individual
MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12611 HICKMAN PL, DENVER, CO 80239-6204
(303) 475-3916
Mailing address
12611 HICKMAN PL, DENVER, CO 80239-6204
(303) 475-3916
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000582
CO
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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