Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIERRA LEANNE JACKSON, TATTOO LICENSE
ActiveTIERRA LEANNE JACKSON, TATTOO LICENSE is a Occupational Therapy Assistant healthcare provider located in SPRINGFIELD, Missouri. NPI 1366267627 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · SPRINGFIELD, MO
Registration Details
- NPI Number
- 1366267627
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 20, 2024 (1.75158901829 yrs)
- Last Updated
- Nov 20, 2024
- Licenses
-
2021043963 (MO)2021043963 (MO)
Practice Information
- Address
-
3322 S CAMPBELL AVE # XSPRINGFIELD, MO, 658074980Browse MO providers · Browse ZIP 65807
- Phone
- 4177715540
- Primary Specialty
-
Occupational Therapy Assistant
225400000X
- Additional Specialty
- Technician, Health Information
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.