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Individual

ORTAGUS DAVOUR JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CERTIFICATE

Contact information

Practice address
18939 SCHOENHERR ST, DETROIT, MI 48205-2205
(313) 300-7599
Mailing address
18939 SCHOENHERR ST, DETROIT, MI 48205-2205
(313) 300-7599

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
172V00000X
MI

Other

Enumeration date
03/18/2026
Last updated
03/24/2026
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