Individual
BRYAN MICHAEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 COLLEGE AVE STE 310, HOLLAND, MI 49423-2982
(616) 426-9034
Mailing address
170 COLLEGE AVE STE 310, HOLLAND, MI 49423-2982
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6851117238
MI
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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