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1609348770
TECHINA CHANTA JACKSON
XENIA, OH
NPI
1609348770
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: OH 161767)
Enumeration Date
2018-12-29
Last Update Date
2018-12-29
Business Address
TECHINA CHANTA JACKSON CDCA 161767
515 MARTIN DR
XENIA, OH 45385-1615
Phone number: 937-562-2400
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Mailing Address
TECHINA CHANTA JACKSON CDCA 161767
515 MARTIN DR
XENIA, OH 45385-1615
Phone number: 773-815-4908
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