Search › Ohio › 171M00000X
Donovan Jackson
NPI 1710666938 · on the registry since 2023 · sole proprietor
Practice
- Address
- 765 West St
Wadsworth, OH 44281 - Phone
- (234) 799-0653
- Organisation at this address
- Pure Mental Behavioral Health
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Also registered as
- 106S00000X
- Sex
- Male
- Record last updated
- 2024-11-04
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