Individual
BRANDY ANTOINETTE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9250 MILES PARK AVE, CLEVELAND, OH 44105-5166
(216) 417-0216
Mailing address
9250 MILES PARK AVE, CLEVELAND, OH 44105-5166
(216) 417-0216
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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