Individual
KATHRYN ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 ARROWHEAD TRL, WARNER ROBINS, GA 31088-5390
(478) 333-6363
(478) 666-6076
Mailing address
905 ARROWHEAD TRL, WARNER ROBINS, GA 31088-5390
(478) 333-6363
(478) 666-6076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006925
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003205498A
—
GA
Enumeration date
04/06/2018
Last updated
02/04/2019
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