Organization
HAWANYA JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HAWANYA ABENA JACKSON BA, RSST, QIDP (INDEPENDENT SUPPORT COORDINATOR)
(313) 942-5230
Entity
Organization
Contact information
Practice address
2425 ATKINSON ST, DETROIT, MI 48206-2057
(313) 942-5230
Mailing address
2425 ATKINSON ST, DETROIT, MI 48206-2057
(313) 942-5230
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6803085548
MI
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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