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1346814860
AMANDA FAITH JACKSON
ST PETERSBURG, FL
NPI
1346814860
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: FL OT21915)
Enumeration Date
2021-05-19
Last Update Date
2021-05-19
Business Address
AMANDA FAITH JACKSON OTR/L
4201 31ST ST S
ST PETERSBURG, FL 33712-4051
Phone number: 727-867-1104
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Mailing Address
AMANDA FAITH JACKSON OTR/L
9038 MANORWOOD RD
LAUREL, MD 20723-1390
Phone number: 301-821-2644
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