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

Individual provider Occupational Therapy Assistant · NPI 1316419443

Gwennetta Patrice Jackson, COTA is an Occupational Therapy Assistant in Lexington, South Carolina. Licensed in South Carolina. Registered with an NPI since 2018.

Licensed in
SC
In the registry since
2018
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

700 Davega Dr
Lexington, SC 29073-9698
Phone: (803) 796-8731
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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 4800 (SC)

Record details

NPI number1316419443
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorNo
NPI enumeratedDecember 31, 2018
Last updated in NPPESDecember 31, 2018

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