| NPI | 1093239188 |
|---|---|
| Former Name | CIERRA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CO 0000889) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NM 3522) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-08-09 |