Individual
CAMILLE JEWELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8181 N WAYNE RD APT S2147, WESTLAND, MI 48185-3842
(313) 529-0006
Mailing address
8181 N WAYNE RD APT S2147, WESTLAND, MI 48185-3842
(313) 529-0006
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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