Individual
ELYSHUA RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1550 OLD HENDERSON RD STE N-271, COLUMBUS, OH 43220-3626
(614) 456-7334
Mailing address
3053 E HUDSON ST, COLUMBUS, OH 43219-1632
(614) 537-2240
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2405083
OH
Other
Enumeration date
04/09/2024
Last updated
01/02/2025
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