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

Specialty	Code	License #	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 11 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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