Individual
COURTNEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41521 W 11 MILE RD # NOV, NOVI, MI 48375-1803
(248) 299-0030
Mailing address
1661 N VAN BUREN ST, MILWAUKEE, WI 53202-2017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801116757
MI
Other
Enumeration date
09/11/2017
Last updated
12/01/2025
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