Individual
SARAH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32715 DORSEY ST, WESTLAND, MI 48186-4755
(734) 641-1141
Mailing address
6863 FELLRATH ST, TAYLOR, MI 48180-1503
(313) 681-8108
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2019
Last updated
12/17/2020
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