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1477896876
KELLY A JACKSON
STATEN ISLAND, NY
NPI
1477896876
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NY 017963)
Enumeration Date
2013-04-03
Last Update Date
2013-04-03
Business Address
Miss KELLY A JACKSON OTR/L
178 MANILA AVE
STATEN ISLAND, NY 10306-5608
Phone number: 718-667-4703
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Mailing Address
Miss KELLY A JACKSON OTR/L
178 MANILA AVE
STATEN ISLAND, NY 10306-5608
Phone number: 718-667-4703
Copy
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