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Autumn Marie Jackson
Peer Specialist in Logan, Ohio
NPI 1053042887

Autumn Marie Jackson is a Peer Specialist based in Logan, OH. Autumn Marie Jackson practices in Logan, OH. The NPI Number for Autumn Marie Jackson is 1053042887 and holds a License No. APS.003224 (Ohio).

The current practice location address for Autumn Marie Jackson is 549 E Front St, Logan, OH and can be reached out via phone at 740-407-8697.

Location: 549 E Front St, Logan, OH, 43138-1717
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053042887
Provider Name
Autumn Marie Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
549 E Front St, Logan, OH, 43138-1717
Phone Number
740-407-8697
Fax Number
Provider Enumeration Date
06/22/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
549 E Front St
City
Logan
State
Ohio
Zip
43138-1717
Phone Number
740-407-8697
Fax Number
person
Provider Business Mailing Address Details
Address
549 E Front St
City
Logan
State
Ohio
Zip
43138-1717
Phone Number
740-407-8697
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
APS.003224 (Ohio)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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