TANJA DECARLO-JACKSON

MADISON HEIGHTS, MI
NPI1073722161
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-05-22
Last Update Date2007-07-08
Business Address
-- TANJA DECARLO-JACKSON
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071-2651
Phone number: 248-547-2223
Mailing Address
-- TANJA DECARLO-JACKSON
19134 MONTROSE ST
DETROIT, MI 48235-2309
Phone number: 313-653-4652