Individual
MRS. DONNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
141 LLOYD RD, WEST UNION, OH 45693-8974
(937) 544-5586
Mailing address
287 W MAPLE LEAF RD, MAYSVILLE, KY 41056-8138
(606) 564-8243
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1324
KY
235Z00000X
Speech-Language Pathologist
Primary
5533
OH
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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