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1053650085
AYESHA IMAN JACKSON
LAUREL, MD
NPI
1053650085
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MD 06246)
Enumeration Date
2013-02-12
Last Update Date
2013-02-12
Business Address
AYESHA IMAN JACKSON OT
14409 GREENVIEW DR
LAUREL, MD 20708-3293
Phone number: 301-498-8100
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Mailing Address
AYESHA IMAN JACKSON OT
14409 GREENVIEW DR
LAUREL, MD 20708-3293
Phone number: 301-498-8100
Copy
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