Individual
DESTINY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HAS
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2411200
OH
1041C0700X
Clinical Social Worker
23003122
OH
171M00000X
Case Manager/Care Coordinator
—
—
237700000X
Hearing Instrument Specialist
IL.03403
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0325500
—
OH
Enumeration date
08/13/2020
Last updated
08/26/2024
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