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Individual

DANIELLE NICOLE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LSW

Contact information

Practice address
2057 S LIMESTONE ST, SPRINGFIELD, OH 45505-4727
(937) 226-9787
Mailing address
5937 CHARLESGATE RD, HUBER HEIGHTS, OH 45424-1120
(937) 270-1951

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1450971
OH

Other

Enumeration date
02/01/2021
Last updated
02/01/2021
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