Individual
MS. ALICIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
79 W ALEXANDRINE, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Mailing address
79 W ALEXANDRINE, DETROIT, MI 48201-2015
(313) 550-2502
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011272
MI
Other
Enumeration date
02/04/2013
Last updated
01/31/2017
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