Individual
MRS. HARUMBEE FOWLER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4571 W OUTER DR, 29510 7 MILE RD, LIVONIA, MI 48152, DETROIT, MI 48235-1223
(313) 342-3064
(313) 345-9906
Mailing address
4571 W OUTER DR, DETROIT, MI 48235-1223
(313) 342-3064
(313) 345-9906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005629
—
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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