Provider Demographics
NPI:1457246340
Name:DOWNARD, JACQUELINE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:DOWNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64887 MEEKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MC ARTHUR
Mailing Address - State:OH
Mailing Address - Zip Code:45651-8499
Mailing Address - Country:US
Mailing Address - Phone:740-395-4396
Mailing Address - Fax:
Practice Address - Street 1:64887 MEEKSVILLE RD
Practice Address - Street 2:
Practice Address - City:MC ARTHUR
Practice Address - State:OH
Practice Address - Zip Code:45651-8499
Practice Address - Country:US
Practice Address - Phone:740-395-4396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 225800000X
OH174400000X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171400000XOther Service ProvidersHealth & Wellness Coach
No174400000XOther Service ProvidersSpecialist
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist