Individual
JACQUELYN KELLY HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20549 STOUT ST, DETROIT, MI 48219-1428
(313) 766-5846
Mailing address
5477 S. PICCADILLY CIRCLE, WEST BLOOMFIELD, MI 48322-1446
(248) 752-2077
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
R312086
MI
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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