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
Mailing address315 Howard Blvd, Longwood, FL 32750-4616

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