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

Mrs. Chante Olivia Jackson, COTAL

Individual provider Occupational Therapist · NPI 1497523641

Mrs. Chante Olivia Jackson, COTAL is an Occupational Therapist in Southfield, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

16112 Mount Vernon St
Southfield, MI 48075-3188
Phone: (313) 617-8398
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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 5202006981 (MI)
Occupational Therapist Taxonomy 225X00000X · Licence 5202006981 (MI)

Record details

NPI number1497523641
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTAL
Sole proprietorYes
NPI enumeratedDecember 18, 2023
Last updated in NPPESDecember 18, 2023
Certification dateJuly 25, 2021

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