TYWANNA LASHEA JACKSON

FORT WAYNE, IN
NPI1376662015
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IN  32001156A)
Enumeration Date2007-03-27
Last Update Date2007-07-08
Business Address
Miss TYWANNA LASHEA JACKSON COTA
2237 ENGLE RD
FORT WAYNE, IN 46809-1404
Phone number: 260-747-2353
Mailing Address
Miss TYWANNA LASHEA JACKSON COTA
PO BOX 11532
FORT WAYNE, IN 46859-1532
Phone number: 260-348-0124
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