Individual
DARRIELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1829 E 55TH ST, CLEVELAND, OH 44103-3601
(216) 881-7882
Mailing address
2950 E 126TH ST, CLEVELAND, OH 44120-2640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
188988
OH
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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