Individual provider · Type 1 NPI

Tywanna Lashea Jackson, COTA

Occupational Therapy Assistant · Fort Wayne, IN

NPI number 1376662015 Active

Practice location

2237 Engle Rd
Fort Wayne, IN 46809-1404

Mailing address

PO Box 11532
Fort Wayne, IN 46859-1532

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X32001156A (IN)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1376662015

Tywanna Lashea Jackson, COTA's National Provider Identifier is 1376662015, issued on Mar 27, 2007. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 8, 2007.