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Individual

AMY JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
118 DAVE AVE APT 306, LEBANON, OH 45036-2728
(513) 850-9570
Mailing address
118 DAVE AVE APT 306, LEBANON, OH 45036-2728
(513) 850-9570

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
Primary

Other

Enumeration date
07/01/2024
Last updated
07/01/2024
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