| NPI | 1104915503 |
|---|---|
| Doing Business As | GLORIA JACKSON |
| Entity Type | Organization |
| Authorized Contact | GLORIA JACKSON CEO 313-963-7949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801019214) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |