Individual
PAMELA DEE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
305 NE LOOP 820, BUSINESS TOWER 1 SUITE 200, HURST, TX 76053-7209
(817) 292-8787
Mailing address
5051 BARCELONA TRL, GRAND PRAIRIE, TX 75052-0937
(818) 281-6582
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213569
TX
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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