ELLSWORTH JACKSON

MADISON HEIGHTS, MI
NPI1467660183
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MI  6801035402)
Enumeration Date2007-05-18
Last Update Date2007-07-08
Business Address
-- ELLSWORTH JACKSON MSW
27351 DEQUINDRE RD
MADISON HEIGHTS, MI 48071-3487
Phone number: 248-967-7320
Mailing Address
-- ELLSWORTH JACKSON MSW
20736 KNOB WOODS DR APT 201
SOUTHFIELD, MI 48076-4018
Phone number:
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