Tashata Re'kal Jackson, COTA

NPI #1053892604 in Kilgore, Texas

Provider Information

NPI Number
1053892604
Entity Type
Individual
Name
Tashata Re'kal Jackson, COTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Occupational Therapy Assistant
Credential
COTA
Enumeration Date
Aug 22, 2018
Last Updated
Aug 22, 2018

Practice Location

Address
2700 S HENDERSON BLVD
State
Texas
ZIP Code
75662-4033
Phone
(903) 984-3511

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant

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