Individual
MRS. AMBROSIA NOTTAGE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,CRC
Contact information
Practice address
53435 GRAND RIVER AVE, NEW HUDSON, MI 48165-8521
(517) 492-0517
Mailing address
22550 HALL RD, CLINTON TWP, MI 48036-1189
(586) 850-3011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012758
MI
Other
Enumeration date
07/12/2012
Last updated
04/15/2026
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