Individual
MRS. CARMEN JACKSON JOEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACHLEOR OF ARTS
Contact information
Practice address
12089 PENROD ST, DETROIT, MI 48228-1171
(313) 865-1500
(313) 865-1477
Mailing address
12089 PENROD ST, DETROIT, MI 48228-1171
(313) 865-1500
(313) 865-1477
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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