(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003532854
Provider Name: KASSIDY S JACKSON
Entity Type: Individual
Taxonomy Code: 101YM0800X
Specialty: Counselor
License Number:
Most Important Dates
Enumeration Date: 10/13/2022
Last Updated: 10/13/2022
Provider Practice Location
3242 E MAIN ST STE 2
COLUMBUS
OH
432133807
Practice Location Phone/Fax
Phone: 6145004150
Fax: 6145004150
Provider Mailing Location
3242 E MAIN ST STE 2
COLUMBUS
OH
432133807
Provider Mailing Phone/Fax
Phone:
Fax: 6145004150