Individual
JOAN LYNNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
660 S CORONADO DR, SIERRA VISTA, AZ 85635-3386
(520) 459-5900
Mailing address
PO BOX 55, SIERRA VISTA, AZ 85636-0055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
AA353292
AZ
Other
Enumeration date
07/06/2008
Last updated
07/06/2008
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