Individual
BRENDA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19431 MONTEREY AVE, EUCLID, OH 44119-1504
(216) 256-8939
Mailing address
19431 MONTEREY AVE, EUCLID, OH 44119-1504
(216) 256-8939
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
40112298710
OH
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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