National Provider Identifier
Michele Mary Jackson, OTR/L
Michele Mary Jackson, OTR/L is listed in the NPPES registry with a primary specialty of Specialist in Lockport, NY and a listed phone number of (716) 434-4970.
Profile Overview
- NPI
- 1013292929
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- October 12, 2011
- Last Updated
- October 12, 2011
Practice Location
- 5669 Wendy Cir
- Lockport, NY 14094-6015
Phone: (716) 434-4970
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1013292929
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Michele
- Middle Name
- Mary
- Credential
- OTR/L
- Mailing Street Address
- 5669 Wendy Cir
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094-6015
- Mailing Country
- US
- Mailing Phone
- (716) 434-4970
- Practice Street Address
- 5669 Wendy Cir
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-6015
- Practice Country
- US
- Practice Phone
- (716) 434-4970
- Enumeration Date
- October 12, 2011
- Last Updated
- October 12, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)
- Other Identifiers
- 003569-1 (NY, Occupational Therapist)