| NPI | 1164815957 |
|---|---|
| Former Name | RYAN LEA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OK 1986) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2015007590) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2022-03-07 |