Individual
DEVONNA C. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 E THIRD ST, DAYTON, OH 45402-5804
(937) 301-4539
Mailing address
2330 E THIRD ST, DAYTON, OH 45402-5804
(937) 580-4488
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/25/2013
Last updated
12/12/2016
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