ORTAGUS DAVOUR JACKSON

DETROIT, MI
NPI1376491258
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI  172v00000x)
Enumeration Date2026-03-18
Last Update Date2026-03-24
Business Address
ORTAGUS DAVOUR JACKSON certificate
18939 SCHOENHERR ST
DETROIT, MI 48205-2205
Phone number: 313-300-7599
Mailing Address
ORTAGUS DAVOUR JACKSON certificate
18939 SCHOENHERR ST
DETROIT, MI 48205-2205
Phone number: 313-300-7599
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