Individual
MS. DIANA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
481 GINGER PL, TROTWOOD, OH 45426-3034
(937) 304-0942
Mailing address
481 GINGER PL, TROTWOOD, OH 45426-3034
(937) 304-0942
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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