Individual
ANDREA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10400 BLACKLICK EASTERN RD, PICKERINGTON, OH 43147-8235
(614) 726-7359
Mailing address
6630 ORLEANS CT, CINCINNATI, OH 45224-1251
(513) 834-2082
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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