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General NPI Number Information
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NPI Number | 1639454929
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Entity Type | Individual
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Provider Name | ERIN L JACKSON MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 20 BARROWS ST
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City | BRUNSWICK
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State | ME
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Zip | 04011-3214
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Country | US
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Telephone | 207-319-1900
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Fax | 207-725-1704
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Provider Business Mailing Address
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Address Line | 79 BEECH HILL RD
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City | FREEPORT
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State | ME
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Zip | 04032-6718
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Country | US
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Telephone | 207-712-7068
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT1815
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License Number State | ME
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