DIANE R JACKSON

MANSFIELD, OH
NPI1811056658
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: OH  E.0003808-SUPV)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: OH  E.0003808-SUPV)
101YP1600X Counselor, Pastoral
(Licence: OH  E.0003808-SUPV)
Enumeration Date2006-12-07
Last Update Date2007-07-08
Business Address
-- DIANE R JACKSON
87 W 4TH ST
MANSFIELD, OH 44903-1672
Phone number: 419-526-4603
Mailing Address
-- DIANE R JACKSON
PO BOX 1573
MANSFIELD, OH 44901-1573
Phone number: 419-526-4603