Individual
MS. KASSANDRA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
17940 FARMINGTON RD, LIVONIA, MI 48152-4444
(517) 234-3627
Mailing address
5420 PROVINCIAL DR, BLOOMFIELD HILLS, MI 48302-2539
(248) 830-7782
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093643
MI
1041C0700X
Clinical Social Worker
6801093643
MI
Other
Enumeration date
07/30/2012
Last updated
06/10/2024
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