Individual
JACKSON MOREHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 W MAIN ST STE 207, NORTHVILLE, MI 48167-1584
(734) 738-0897
Mailing address
5425 S KING ST, LITTLETON, CO 80123-2910
(970) 988-4558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401222657
MI
103T00000X
Psychologist
6301018373
MI
Other
Enumeration date
02/24/2020
Last updated
08/01/2022
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