Jackson, Kelly I

Jackson, Kelly I is an individual health care provider with primary practice located at 601 S Edwin C Moses Blvd Samaritan Behavioral Health Inc, 1St Floor Nw Bldg, Dayton OH 45417-3424. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Jackson, Kelly I can be contacted via phone (937) 734-8333.

Contact Information

Primary practice address
601 S Edwin C Moses Blvd Samaritan Behavioral Health Inc, 1St Floor Nw Bldg Dayton OH 45417-3424
Phone: (937) 734-8333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1487023032
LBN Legal business name Jackson, Kelly I
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2015
Last updated Sep 24th, 2015 - about 10 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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