Individual
MS. LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P.
Contact information
Practice address
456 PLYMOUTH AVE NE STE B, GRAND RAPIDS, MI 49505
(616) 345-0414
Mailing address
2324 SOUTHGATE DR SE, KENTWOOD, MI 49508-0951
(616) 345-0414
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301009521
MI
Other
Enumeration date
10/04/2013
Last updated
09/24/2025
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