Individual
CAMILLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5850 RIDGE RD, PARMA, OH 44129-3169
(440) 990-4467
Mailing address
4600 MONTGOMERY RD, CINCINNATI, OH 45212-2697
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.183689
OH
Other
Enumeration date
12/13/2023
Last updated
12/19/2023
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