Individual
KAREN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6564 CRESCENT GRN, WEST BLOOMFIELD, MI 48322-1323
(313) 695-3469
Mailing address
6564 CRESCENT GRN, WEST BLOOMFIELD, MI 48322-1323
(313) 695-3469
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401015668
MI
Other
Enumeration date
08/17/2016
Last updated
10/05/2016
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