Individual
CHANTE RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28082 HOOVER RD APT 3, WARREN, MI 48093-4166
(313) 614-1238
Mailing address
28082 HOOVER RD APT 3, WARREN, MI 48093-4166
(313) 614-1238
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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