Individual
TANYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2936 GEORGIA AVE, SALINA, KS 67401-7948
(785) 825-6954
Mailing address
424 N PUTNAM ST, BENNINGTON, KS 67422-9424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01248
KS
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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