Individual
KATIE MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3600 N SAGINAW RD, MIDLAND, MI 48640-2301
(989) 510-7626
Mailing address
3792 DEIBEL DR, SAGINAW, MI 48603-7229
(989) 860-1601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015169
MI
101YP2500X
Professional Counselor
6401015169
—
Other
Enumeration date
04/10/2019
Last updated
06/11/2019
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