Individual
JESSICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
575 S MAIN ST, PLYMOUTH, MI 48170-1778
(734) 451-7800
Mailing address
5302 WESTLAKE CIR, VAN BUREN TWP, MI 48111-6114
(517) 599-5999
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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