Individual
JESSICA MARIE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDE
Contact information
Practice address
33 WEST ST, JACKSON, OH 45640-1564
(740) 395-6912
Mailing address
33 WEST ST, JACKSON, OH 45640-1564
(740) 395-6912
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
4064949
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0271855
—
OH
Enumeration date
09/11/2020
Last updated
09/11/2020
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