MEDICARE: OT WITH JACKIE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1871454322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OT WITH JACKIE PLLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR # 23360
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	512-630-2873
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 BALCONES DR # 23360
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	512-630-2873
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	JACLYN COLLINS
Credential	:	OTR, MOT, SEP
Telephone Number	:	651-808-2497

Provider Enumeration Date	:	11/22/2025
Last Update Date	:	12/02/2025

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