Individual
SHELBY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17920 WINSOME, FRASER, MI 48026-3168
(313) 422-5832
Mailing address
40583 CANTERBURY DR, CLINTON TOWNSHIP, MI 48038-7120
(586) 873-5504
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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