Individual
MS. CHRISTY DANIELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
409 COURTLAND ST, ELYRIA, OH 44035-3167
(440) 324-5709
Mailing address
409 COURTLAND ST, ELYRIA, OH 44035-3167
(440) 324-5709
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PN102812
OH
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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