Individual
MISS ELEANOR JAYNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5273 BROADVIEW RD, PARMA, OH 44134-1626
(216) 749-6650
Mailing address
3490 EDISON RD, CLEVELAND HTS, OH 44121-1526
(216) 291-2850
(216) 291-2850
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-2341
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217475
'ANTHEM BLUE CROSS AND B'
OH
05
—
0842995
—
OH
Enumeration date
09/24/2007
Last updated
11/28/2007
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