Individual
LENORA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18518 SAINT MARYS ST, DETROIT, MI 48235-2964
(313) 623-6235
Mailing address
18518 SAINT MARYS ST, DETROIT, MI 48235-2964
(313) 623-6235
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2136060208
MI
Other
Enumeration date
01/26/2020
Last updated
03/12/2021
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