Individual
ACHAUNDAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1579 S HIGH ST, COLUMBUS, OH 43207-1804
(614) 271-6907
Mailing address
PO BOX 7957, COLUMBUS, OH 43207-0957
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.182524
OH
101YM0800X
Mental Health Counselor
CDCA.182524
OH
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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