Individual
THERESA A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
3112 33RD ST NE, CANTON, OH 44705-3869
(330) 454-6430
Mailing address
2308 42ND ST NW, CANTON, OH 44709-2113
(336) 587-9076
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
OH
Other
Enumeration date
01/31/2017
Last updated
11/21/2023
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