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Individual

JACQUES SHORT II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9559 MIDDLEBELT RD, LIVONIA, MI 48150-3009
(269) 459-1818
Mailing address
509 N EATON ST, ALBION, MI 49224-1243
(517) 499-8493

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361008155
MI

Other

Enumeration date
04/25/2016
Last updated
10/21/2025
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