Tierra Leanne Jackson, TATTOOLICENSE
Tierra Leanne Jackson, TATTOOLICENSE is a Rehabilitation Practitioner in Springfield, Missouri. Licensed in Missouri. Registered with an NPI since 2024.
- Licensed in
- MO
- In the registry since
- 2024
- Specialties on file
- 2
Practice location Address checks out
3322 S Campbell Ave # XSpringfield, MO 65807-4980
Phone: (417) 771-5540
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Rehabilitation Practitioner (primary) | Taxonomy 225400000X · Licence 2021043963 (MO) |
|---|---|
| Other Technician | Taxonomy 247200000X · Licence 2021043963 (MO) |
Record details
| NPI number | 1366267627 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | TATTOOLICENSE |
| Sole proprietor | No |
| NPI enumerated | November 20, 2024 |
| Last updated in NPPES | November 20, 2024 |
| Certification date | November 20, 2024 |