Individual
SANDRA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
435 AVIS AVE NW, MASSILLON, OH 44646-3555
(330) 837-1741
Mailing address
1614 CEDAR KNOLL AVE NW, MASSILLON, OH 44646
(330) 830-3845
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA706
OH
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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