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1164061073
TAMARA T JACKSON
GRAND RAPIDS, MI
NPI
1164061073
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-12-26
Last Update Date
2019-12-26
Business Address
TAMARA T JACKSON
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-4304
Phone number: 616-456-1443
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Mailing Address
TAMARA T JACKSON
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-4304
Phone number:
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