Jackson, Brianna L

Jackson, Brianna L is an individual health care provider with primary practice located at 1200 E Pecan St , Altus OK 73521-6192. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Jackson, Brianna L can be contacted via phone (580) 379-5820.

Contact Information

Primary practice address
1200 E Pecan St Altus OK 73521-6192
Phone: (580) 379-5820
Fax: (580) 379-5829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 23818 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2309 Nebraska
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 5335 Oklahoma

Profile Details

NPI number 1568021475
LBN Legal business name Jackson, Brianna L
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2019
Last updated Apr 3rd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568021475 NPPES
Oklahoma MEDICAID 201089720A

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