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

Miranda L Jackson, OTR/L

Individual provider Physical Therapist · NPI 1235718537

Miranda L Jackson, OTR/L is a Physical Therapist in Dearborn, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
Specialties on file
2
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

1360 Porter St
Dearborn, MI 48124-2890
Phone: (313) 689-5188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X (MI)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1235718537
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedApril 5, 2021
Last updated in NPPESSeptember 20, 2021
Certification dateSeptember 20, 2021
Mailing address1360 Porter St, Dearborn, MI 48124-2890

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