Jackson, Stacie W

Jackson, Stacie W is an individual health care provider with primary practice located at 719 Heritage Park Ln , Hoover AL 35226-4198. 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, Stacie W can be contacted via phone (205) 266-5394.

Contact Information

Primary practice address
719 Heritage Park Ln Hoover AL 35226-4198
Phone: (205) 266-5394
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2276 Alabama

Profile Details

NPI number 1225202393
LBN Legal business name Jackson, Stacie W
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2008
Last updated Jul 7th, 2014 - about 11 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 1225202393 NPPES
Alabama Other 2276 OT LICENSE

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