Individual
TAMEKA LATOYA JACKSON -DYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC, CHW
Contact information
Practice address
18983 EDINBOROUGH RD, DETROIT, MI 48219-2825
(248) 694-4402
Mailing address
PO BOX 19171, DETROIT, MI 48219-0171
(248) 694-4402
(313) 731-0476
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
MI
174N00000X
Lactation Consultant (Non-RN)
Primary
L-122778
—
374J00000X
Doula
—
MI
Other
Enumeration date
01/18/2019
Last updated
09/06/2024
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