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Individual

MISS AISHA MARIE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SWA

Contact information

Practice address
3659 GREEN RD STE 220, BEACHWOOD, OH 44122-5715
(216) 260-9022
(216) 260-9038
Mailing address
16314 SEVILLE RD, CLEVELAND, OH 44128-3714
(216) 318-4553

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
W.1300054
OH
104100000X
Social Worker

Other

Enumeration date
06/21/2018
Last updated
10/09/2024
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