KELLY A JACKSON

STATEN ISLAND, NY
NPI1477896876
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: NY  017963)
Enumeration Date2013-04-03
Last Update Date2013-04-03
Business Address
Miss KELLY A JACKSON OTR/L
178 MANILA AVE
STATEN ISLAND, NY 10306-5608
Phone number: 718-667-4703
Mailing Address
Miss KELLY A JACKSON OTR/L
178 MANILA AVE
STATEN ISLAND, NY 10306-5608
Phone number: 718-667-4703