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Contact Information

JESSICA LACKEY, OTR/L
3488 JEFFCO BLVD STE 102
ARNOLD, MO63010-6015
 Phone: 636-464-5439
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JESSICA LACKEY · (Female)

NPI Number 1275395907
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 01/29/2024
Last updated 10/09/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # 2023049568
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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