Individual
MISS QUNISHA LASHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N/A
Contact information
Practice address
1841 N PERRY ST, PONTIAC, MI 48340-2235
(248) 745-4900
Mailing address
190 ROCKWELL AVE, PONTIAC, MI 48341-2259
(248) 579-3448
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/02/2022
Last updated
04/02/2022
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