Individual
AMANDA RACHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S 3RD AVE, BIG RAPIDS, MI 49307-9501
(231) 796-5825
Mailing address
500 S 3RD AVE, BIG RAPIDS, MI 49307-9501
(231) 250-1478
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
MI
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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