Jackson, Anita P

Jackson, Anita P is an individual health care provider with primary practice located at 573 Brookover Ave , Zanesville OH 43701-2101. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jackson, Anita P can be contacted via phone (740) 450-7620.

Contact Information

Primary practice address
573 Brookover Ave Zanesville OH 43701-2101
Fax: (740) 450-7618
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X E1514 Ohio

Profile Details

NPI number 1679620652
LBN Legal business name Jackson, Anita P
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Nov 28th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679620652 NPPES
Ohio Other 311814468031 CARESOURCE
Ohio Other 000000517637 CARESOURCE

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