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General NPI Number Information
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NPI Number | 1871454322
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Entity Type | Organization
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Legal Business Name | OT WITH JACKIE PLLC
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Dates
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Enumeration Date | 11/22/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR # 23360
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 512-630-2873
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR # 23360
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 512-630-2873
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JACLYN COLLINS
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Credential | OTR, MOT, SEP
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Telephone | 651-808-2497
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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 |
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License Number State |
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