Gretchen Jackson
Developmental Therapist in Glenwood, IL. Individual provider (NPI-1).
NPI number1336067321
StatusActive
Last updated in NPPESJul 7, 2026
Details
- NPI
- 1336067321
- Entity type
- Individual (NPI-1)
- Name
- Gretchen Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 7, 2026
- Certification date
- Jul 7, 2026
- Last updated
- Jul 7, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | – | Yes |
Practice location
120 S Rebecca StGlenwood, IL 60425-1622
Phone 708-655-1932
Mailing address
120 S Rebecca StGlenwood, IL 60425-1622
Phone 708-655-1932
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