Kellene Shey Jackson, COTA

Occupational Therapy Assistant · Maitland, FL

Individual Active NPI

NPI number 1770616138

Practice location

1301 W Maitland Blvd
Maitland, FL 32751-4338
Phone
(407) 645-0034

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NPI record

NPI
1770616138
Entity type
Individual (Type 1)
Enumeration date
March 14, 2007
Last updated
January 10, 2010
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Occupational Therapy Assistant Primary 224Z00000X 9463 FL

Mailing address

315 Howard Blvd
Longwood, FL 32750-4616
Phone
(407) 402-3203

About Kellene Jackson

Kellene Shey Jackson, COTA is a healthcare provider registered in the NPI registry with the primary taxonomy Occupational Therapy Assistant (code 224Z00000X). The practice location is 1301 W Maitland Blvd, Maitland, FL 32751-4338. The NPI number 1770616138 was assigned on March 14, 2007 and the record was last updated on January 10, 2010.

Kellene Jackson lists a license in the registry: #9463 (FL) for Occupational Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kellene Shey Jackson, COTA?

The NPI number is 1770616138.

What is the phone number of Kellene Jackson?

The phone number listed for the practice location is (407) 645-0034.

Where is Kellene Jackson located?

1301 W Maitland Blvd, Maitland, FL 32751-4338.

What is the taxonomy code for Kellene Jackson?

The primary taxonomy code is 224Z00000X – Occupational Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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