Individual
SAMANTHA RAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
695 SOUTH ST, CHARDON, OH 44024-1474
(440) 286-1631
Mailing address
41 MARSHALL AVE, APT. 1, AKRON, OH 44303-1412
(330) 502-2532
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1100378
OH
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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