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1396310595
SHANTANIQUE JACKSON
WESTLAND, MI
NPI
1396310595
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2021-05-21
Last Update Date
2021-05-21
Business Address
SHANTANIQUE JACKSON
35300 NANKIN BLVD
WESTLAND, MI 48185-7222
Phone number: 888-355-5433
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Mailing Address
SHANTANIQUE JACKSON
205 E JOLLY RD APT A10
LANSING, MI 48910-6684
Phone number:
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