Individual
DENISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6855
(248) 447-4704
Mailing address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
03/11/2014
Last updated
10/17/2022
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