Individual
AUDREY LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
811 YOUNG ST, YPSILANTI, MI 48198
(734) 352-9474
Mailing address
811 YOUNG ST, YPSILANTI, MI 48198-4021
(734) 352-9474
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801105658
MI
Other
Enumeration date
07/12/2017
Last updated
06/11/2025
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