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Individual

CARLTON JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3101 S GULLEY RD, STE F, DEARBORN, MI 48124-4406
(734) 407-2500
Mailing address
136 WILLIAM ST, SPRINGFIELD, MA 01105-2324
(734) 407-2500

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
04/21/2016
Last updated
04/21/2016
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