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1063619476
KIMBERLY SMITH JACKSON
SLIDELL, LA
NPI
1063619476
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: LA OTT.200084)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
Mrs. KIMBERLY SMITH JACKSON LOTR
2012 RUBICH LN
SLIDELL, LA 70461-1361
Phone number: 985-643-2156
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Mailing Address
Mrs. KIMBERLY SMITH JACKSON LOTR
2012 RUBICH LN
SLIDELL, LA 70461-1361
Phone number: 985-643-2156
Copy
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