Individual
ALISSA NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
929 HARRISON AVE STE 304, COLUMBUS, OH 43215-1346
(614) 940-4868
Mailing address
5101 CORNICE CT, GALENA, OH 43021-9076
(614) 403-1476
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0900346
OH
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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