Individual
MRS. MELINDA W. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1124 N PARK ST STE M, CARROLLTON, GA 30117-2282
(770) 834-0873
(770) 834-6118
Mailing address
150 CLINIC AVE STE 101, CARROLLTON, GA 30117-4402
(770) 834-0873
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002649
GA
Other
Enumeration date
08/20/2008
Last updated
06/24/2025
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