Individual
JABREONA A MACKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17421 TELEGRAPH RD, DETROIT, MI 48219-3165
(313) 531-2500
Mailing address
17421 TELEGRAPH RD, DETROIT, MI 48219-3165
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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