Search › Ohio › 175T00000X
Dominique Jackson
NPI 1689426793 · on the registry since 2024 · sole proprietor
Practice
- Address
- 4114 E 141st St
Cleveland, OH 44128 - Phone
- (216) 501-3289
Registry record
- Primary taxonomy
- 175T00000X
175T00000X
- Also registered as
- 171M00000X
372600000X
376K00000X - Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio