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Individual
KIM M JACKSON
Active
Individual
KIM M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I2506226
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268768
—
OH
Enumeration date
10/15/2010
Last updated
09/22/2025
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