Individual
MS. YAMISHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.A
Contact information
Practice address
11611 GRAYTON ST, DETROIT, MI 48224-1643
(313) 556-4769
(313) 473-8192
Mailing address
7762 ROSEMONT AVE, DETROIT, MI 48228-5426
(313) 658-6938
(313) 473-8192
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
230009497230504
MI
Other
Enumeration date
02/25/2019
Last updated
09/11/2025
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