Organization
JULIE JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE ANN JACKSON LICDC (PROGRAM COORDINATOR)
(614) 620-2284
Entity
Organization
Contact information
Practice address
2206 RIDGEWAY AVE, COLUMBUS, OH 43219-2609
(614) 620-2284
Mailing address
2206 RIDGEWAY AVE, COLUMBUS, OH 43219-2609
(614) 620-2284
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
131049
OH
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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