Individual
LATOYA T JACKOSN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
SUNSHINE TREATMENT IN, 4821 E. MCNICHOLS, DETROIT, MI 48212
(313) 368-4800
Mailing address
20420 TERRELL ST, DETROIT, MI 48234-3209
(313) 218-2626
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
J250488789675
MI
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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