IndividualActive
Jeannine Jackson, COTA/L
NPI 1629667589 · Pediatric Occupational Therapist · Tulsa, OK
Provider details
- NPI number
- 1629667589
- Entity type
- Individual
- Primary specialty
- Pediatric Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
6715 E 41st St
Tulsa, OK 74145-4520
Phone: (918) 806-0106
Approximate (ZIP-level) locationGet directions
Mailing address
622 E Main St
Collinsville, OK 74021-3616
Registry dates
- Enumerated
- 2021-01-14
- Last updated
- 2021-01-14
- Certified
- 2021-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.