Individual
CANDACE DORALEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1470 RANKIN ST, ASHDOWN, AR 71822-3806
(903) 824-6589
Mailing address
1470 RANKIN ST, ASHDOWN, AR 71822-3806
(903) 824-6589
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
213751
TX
224Z00000X
Occupational Therapy Assistant
Primary
OT-A 1072
AR
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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