Individual
MRS. TIFFANY RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA,CCHW
Contact information
Practice address
1490 UNIVERSITY BLVD, HAMILTON, OH 45011-3305
(513) 896-7997
Mailing address
1020 SYMMES RD, FAIRFIELD, OH 45014-1844
(513) 896-8300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
01/20/2022
Last updated
02/02/2023
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