Individual
AMELIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23636 MICHIGAN AVE # 487, DEARBORN, MI 48124-1910
(419) 788-1199
(313) 914-5853
Mailing address
23636 MICHIGAN AVE # 487, DEARBORN, MI 48124-1910
(419) 788-1199
(313) 914-5853
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
E4197J
MI
374U00000X
Home Health Aide
Primary
E4197J
MI
376K00000X
Nurse's Aide
E4197J
MI
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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