Individual
MISS HEATHER CAITLIN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
212 E MAIN ST, GREENVILLE, OH 45331-1913
(937) 548-1635
(937) 548-1500
Mailing address
207 N MAIN ST, HOLLANSBURG, OH 45332-9707
(937) 417-6200
(937) 548-1500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1100675
OH
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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