Individual
SIMONE RENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAS (AJS)
Contact information
Practice address
1044 GILBERT ST, FLINT, MI 48532-3527
(810) 422-9406
(810) 733-7623
Mailing address
6511 DUPONT ST, FLINT, MI 48505-2068
(810) 348-3303
(810) 733-7623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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