Individual
MS. KISHA ELAINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
1840 E 29TH ST, LORAIN, OH 44055-1806
(440) 258-1564
Mailing address
1840 E 29TH ST, LORAIN, OH 44055-1806
(440) 258-1564
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
05/16/2024
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