Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kellene Shey Jackson, COTA

Individual provider Occupational Therapy Assistant · NPI 1770616138

Kellene Shey Jackson, COTA is an Occupational Therapy Assistant in Maitland, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2007
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

1301 W Maitland Blvd
Maitland, FL 32751-4338
Phone: (407) 645-0034
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 9463 (FL)

Record details

NPI number1770616138
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorYes
NPI enumeratedMarch 14, 2007
Last updated in NPPESJanuary 10, 2010

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