IndividualActive
Courtney Jackson
NPI 1043925258 · Environmental Modification Occupational Therapy Assistant · Fayetteville, NC
Provider details
- NPI number
- 1043925258
- Entity type
- Individual
- Primary specialty
- Environmental Modification Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 13569 (NC)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
231 Treetop Dr # 301
Fayetteville, NC 28311-0606
Phone: (951) 870-5501
Approximate (ZIP-level) locationGet directions
Mailing address
411 N Ballance St
Saint Pauls, NC 28384-1211
Registry dates
- Enumerated
- 2023-01-23
- Last updated
- 2023-01-23
- Certified
- 2023-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.