NPI Profile for Dr FELICIA A JACKSON in COLUMBUS, OH.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Health |
163WC1500X | |||
Home Health |
163WH0200X | |||
Psychiatric/Mental Health |
163WP0808X | |||
Psychiatric/Mental Health, Adult |
163WP0809X | |||
Psychiatric/Mental Health, Child & Adolescent |
163WP0807X |
| NPI # | 1497953152 |
|
| Status | Active | |
| Credentials | PH.D., MCJ, RN | |
| Entity | Individual | |
| Enumeration date | 07/04/2007 | |
| Last updated | 07/01/2020 - About 6 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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FELICIA A JACKSON
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