Mrs Chante Olivia Jackson, COTAL - in Southfield, MI

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Mrs Chante Olivia Jackson, COTAL is a Occupational Therapy Assistant based in Southfield, Michigan. Mrs Chante Olivia Jackson is licensed to practice in Michigan (license number 5202006981) and her current practice location is 16112 Mount Vernon St, Southfield, Michigan. She can be reached at her office (for appointments etc.) via phone at (313) 617-8398.

NPI number for Mrs Chante Olivia Jackson is 1497523641 and her current mailing address is 25330 W 6 Mile Rd, Redford, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1497523641.

Contact Information

Mrs Chante Olivia Jackson, COTAL
16112 Mount Vernon St,
Southfield, MI 48075-3188
(313) 617-8398
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Chante Olivia Jackson
GenderFemale
SpecialityOccupational Therapy Assistant
Location16112 Mount Vernon St, Southfield, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1497523641
  • Provider Enumeration Date: 12/18/2023
  • Last Update Date: 12/18/2023

Medical Identifiers

Medical identifiers for Mrs Chante Olivia Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1497523641NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 5202006981 (Michigan)Secondary
224Z00000XOccupational Therapy Assistant 5202006981 (Michigan)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Chante Olivia Jackson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Chante Olivia Jackson, COTAL
25330 W 6 Mile Rd,
Redford, MI 48240-2105

Ph: (313) 531-6874		Mrs Chante Olivia Jackson, COTAL
16112 Mount Vernon St,
Southfield, MI 48075-3188

Ph: (313) 617-8398

Reviews and Comments



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