OTIS JACKSON

MEMPHIS, TN
NPI1053710681
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TA0700X Psychologist, Adult Development & Aging
(Licence: TN  1000000015105)
Enumeration Date2014-08-20
Last Update Date2014-08-20
Business Address
Mr. OTIS JACKSON
3311 KIMBALL AVE
MEMPHIS, TN 38111-3846
Phone number: 901-207-4662
Mailing Address
Mr. OTIS JACKSON
1092 CENTER RIDGE RD
COLLIERVILLE, TN 38017-9207
Phone number: 901-870-6847
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