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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, May 6, 2024 9:28 AM CDT
Next Update: Monday, May 6, 2024 12:00 PM CDT

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JACKSON, JESSICA LYNN
Practice Address: BROAD RIVER REHAB-OK
1400 N WAVERLY ST
PONCA CITY OK 74601

Address last updated on 10/24/2023
Phone #: (580) 762-6668
Fax #:
County: KAY
License: 1470
Dated: 5/19/2014
Expires: 10/31/2024
Temp. Ltr. Issued: 1/10/2014
Temp. Ltr. Expires: 6/26/2014
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2024
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
BROAD RIVER REHAB-OK
1400 N WAVERLY ST
PONCA CITY OK 74601

Phone #: (580) 762-6668
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
TARA CHRISTINE GARNEAU OT 1787
HANNELIE SMIT OT 5387

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