Jackson, Robin Elaine

Jackson, Robin Elaine is an sole proprietor health care provider with primary practice located at 25 Whitney Dr Ste 122 , Milford OH 45150-8400. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Robin Elaine can be contacted via phone (513) 941-4999.

Contact Information

Primary practice address
25 Whitney Dr Ste 122 Milford OH 45150-8400
Phone: (513) 941-4999
Fax: (513) 694-0168
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDCIII.162469 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.166828 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.162999 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDCII.161636 Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C.2405498-TRNE Ohio

Profile Details

NPI number 1821582776
LBN Legal business name Jackson, Robin Elaine
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2018
Last updated Jan 22nd, 2024 - about last year

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 1821582776 NPPES
Ohio MEDICAID 0339385

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