Individual
JACQUELYN SUE ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
77 E WOODBURY DR STE 110, DAYTON, OH 45415-2853
(937) 972-8455
Mailing address
77 E WOODBURY DR STE 110, DAYTON, OH 45415-2853
(937) 789-2519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.185310
OH
171M00000X
Case Manager/Care Coordinator
CDCA.185310
OH
175T00000X
Peer Specialist
1355
OH
Other
Enumeration date
07/17/2019
Last updated
10/28/2025
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