Individual
MS. CHRISTINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801068895
MI
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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