Individual
JACKLYN EWALD
Active
Individual
JACKLYN EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
C.1902396
OH
103TH0100X
Health Service Psychologist
Primary
R389
OR
Other
Enumeration date
01/29/2019
Last updated
07/12/2026
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