Harumbee Fowler Jackson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201005629

Practice address

4571 W Outer Dr
29510 7 Mile Rd, Livonia, Mi 48152
Detroit, MI 48235-1223

Phone

(313) 342-3064

Fax

(313) 345-9906

NPI assigned

Mar 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093835043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4571 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351223",
            "telephone_number": "313-342-3064",
            "fax_number": "313-345-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4571 W OUTER DR",
            "address_2": "29510 7 MILE RD, LIVONIA, MI 48152",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351223",
            "telephone_number": "313-342-3064",
            "fax_number": "313-345-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HARUMBEE",
        "middle_name": "FOWLER",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": "5201005629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jackson, LMSW
• Felicia Jackson
• Florenshia Jackson, CHW
• Frankie Dijonnay Anna-Marie Jackson
• Gloria Jackson, MSW
• Helki Jackson
• Henry Benson Jackson, LLMSW
• Hershel Jackson, MD
• James Jackson
• Jayne Jackson

• Occupational Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.