Individual
DENIQUA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 3336, FARMINGTON HILLS, MI 48333-3336
(248) 470-3628
Mailing address
28951 POWERS ST, WESTLAND, MI 48186-5141
(313) 213-4517
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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