Individual
JACKSON LANWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43533 ELIZABETH ST, MOUNT CLEMENS, MI 48043-1034
(586) 469-5265
Mailing address
551 ALBANY ST, FERNDALE, MI 48220-3333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002491
MI
Other
Enumeration date
11/28/2018
Last updated
07/20/2025
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