Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Darryl Raynor Jackson Jr.

Individual provider Occupational Therapy Assistant · NPI 1205198025

Mr. Darryl Raynor Jackson Jr. is an Occupational Therapy Assistant in Hannibal, Missouri. Licensed in Missouri. Registered with an NPI since 2012.

Licensed in
MO
In the registry since
2012
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Practice location Address checks out

1734 Market St
Hannibal, MO 63401-4025
Phone: (573) 629-0321
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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 201000472 (MO)

Record details

NPI number1205198025
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 8, 2012
Last updated in NPPESJune 8, 2012

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