Whalio Doctors

NPI 1356777411

Jackie D Nickson, OTDOTRL

Practitioner Occupational Therapist Horn Lake, MS

Practice location

Address
6664 Sinclair Dr, Horn Lake, MS 38637-2598
Phone
(901) 230-4982
Fax
(662) 393-2673

Registered specialties (6)

Occupational Therapist Primary
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence OT1986 (MS)
Occupational Therapist
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence 1986 (MS)
Physical Therapist
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X
Speech-Language Pathologist
Speech, Language and Hearing Service Providers Taxonomy 235Z00000X
Occupational Therapy Assistant
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X
Physical Therapy Assistant
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X

Registry record

NPI
1356777411
Entity type
Individual
Sex (as registered)
Female
NPI issued
20 Sep 2013
Record last updated
12 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.