Organization
THE OPEN ROAD COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORRYN HELEN JACKSON LPC (OWNER)
(734) 678-3097
Entity
Organization
Contact information
Practice address
717 W ELLSWORTH RD, ANN ARBOR, MI 48108-3343
(734) 678-3097
Mailing address
1270 WARNER ST, YPSILANTI, MI 48197-4658
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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