Nickson, Jackie D

Nickson, Jackie D is an sole proprietor health care provider with primary practice located at 6664 Sinclair Dr , Horn Lake MS 38637-2598. She recently has 5 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Nickson, Jackie D can be contacted via phone (901) 230-4982.

Contact Information

Primary practice address
6664 Sinclair Dr Horn Lake MS 38637-2598
Phone: (901) 230-4982
Fax: (662) 393-2673
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT1986 Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1986 Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X Mississippi
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X Mississippi

Profile Details

NPI number 1356777411
LBN Legal business name Nickson, Jackie D
Credentials OTD, OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2013
Last updated Jan 12th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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