Yolanda Sheree Jackson-Reid, OTR/L

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

3612 Issued in AZ

Practice address

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Phone

(602) 347-2600

NPI assigned

Oct 4, 2007

Last updated

Oct 4, 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

State licenses

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1932397866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17238 N 185TH LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743923",
            "telephone_number": "928-252-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-REID",
        "first_name": "YOLANDA",
        "middle_name": "SHEREE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "AZ",
            "license": "3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Desirae Jackson
• Mary Christine Jackson, P.T.
• Morgan Renee Jackson

• Local Education Agency (LEA) in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Local Education Agency (LEA) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.