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Individual

MS. CHRISTINE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
9115 WARWICK, DETROIT, MI 48228
(810) 287-6198
Mailing address
9115 WARWICK ST, DETROIT, MI 48228-1730
(810) 287-6198

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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