Individual
MS. ALTROSIUS J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8809 JOHN C. LODGE, DETROIT, MI 48202
(313) 887-6749
(313) 876-0532
Mailing address
8809 JOHN C. LODGE, DETROIT, MI 48202
(313) 887-6749
(313) 876-0532
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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