Individual
ZANNIE ROY JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
36801 ANN ARBOR TRL, LIVONIA, MI 48150-3422
(313) 728-1884
Mailing address
36801 ANN ARBOR TRL, LIVONIA, MI 48150-3422
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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