Kevin D. Jackson

NPI #1982376943 in Yellow Springs, Ohio

Provider Information

NPI Number: 1982376943
Entity Type: Individual
Name: Kevin D. Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Sep 29, 2021
Last Updated: Sep 29, 2021

Practice Location

Address: 502 S HIGH ST APT D
City: Yellow Springs
State: Ohio
ZIP Code: 45387-1565
Phone: (937) 287-5353

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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