Individual
PROF. RICKEY T. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY. S.
Contact information
Practice address
20600 EUREKA RD, SUITE 819, TAYLOR, MI 48180-5343
(734) 285-8282
Mailing address
17360 BIRCHCREST DR, DETROIT, MI 48221-2733
(313) 861-4027
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301008412
MI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
07/14/2006
Last updated
09/11/2025
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