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1477211019
KELLY A JACKSON
DETROIT, MI
NPI
1477211019
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2021-12-01
Last Update Date
2021-12-01
Business Address
KELLY A JACKSON
24424 W MCNICHOLS RD
DETROIT, MI 48219-3653
Phone number: 313-531-2500
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Mailing Address
KELLY A JACKSON
4716 ENNISMORE DR
CLARKSTON, MI 48346-3619
Phone number: 248-778-7807
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