Individual
JESSICA JO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
408 E IRON AVE, DOVER, OH 44622-2108
(330) 447-6091
Mailing address
408 E IRON AVE, DOVER, OH 44622-2108
(330) 447-6091
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
0214919
OH
374U00000X
Home Health Aide
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0214919
—
OH
Enumeration date
05/20/2021
Last updated
03/29/2024
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