Individual
LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3869 TERRYBROOK RD, WEST BLOOMFIELD, MI 48322-1737
(248) 932-3935
Mailing address
3869 TERRYBROOK RD, WEST BLOOMFIELD, MI 48322-1737
(248) 932-3935
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013032
MI
Other
Enumeration date
11/13/2015
Last updated
11/13/2015
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