Individual
ANDREA JEANINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2036 WOOD ST, MUSKEGON, MI 49444-1153
(231) 408-8500
Mailing address
2036 WOOD ST, MUSKEGON, MI 49444-1153
(231) 408-8500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/22/2013
Last updated
09/22/2013
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