Individual
JACKLYN EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 45417
(937) 734-8333
Mailing address
601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 45417
(937) 734-8333
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
C.1902396
OH
Other
Enumeration date
01/29/2019
Last updated
07/01/2020
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