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General NPI Number Information
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NPI Number | 1518939362
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Entity Type | Individual
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Provider Name | JENNIFER ANN JACKSON-WOHL D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 201 5TH ST NE STE 4
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City | BARBERTON
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State | OH
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Zip | 44203-3017
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Country | US
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Telephone | 330-745-7263
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Fax | 330-745-7806
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Provider Business Mailing Address
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Address Line | 201 5TH ST NE STE 4
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City | BARBERTON
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State | OH
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Zip | 44203-3017
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Country | US
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Telephone | 330-745-7263
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Fax | 330-745-7806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34008164
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License Number State | OH
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