Individual
LISA LYNNETTE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
501 N MAPLE RD, ANN ARBOR, MI 48103-2827
(800) 395-3223
Mailing address
501 N MAPLE RD, ANN ARBOR, MI 48103-2827
(800) 395-3223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451016062
MI
Other
Enumeration date
06/16/2017
Last updated
09/19/2021
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