Individual
AMANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 S MAIN ST STE 240, DAYTON, OH 45402-2070
(937) 248-1264
Mailing address
31 S MAIN ST STE 240, DAYTON, OH 45402-2070
(937) 248-1264
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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