DERRICK JEROME JACKSON

PONTIAC, MI
NPI1588928626
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MI  6801094410)
Enumeration Date2012-07-03
Last Update Date2012-07-03
Business Address
Mr. DERRICK JEROME JACKSON LLMSW
114 ORCHARD LAKE RD
PONTIAC, MI 48341-2244
Phone number: 248-858-7766
Mailing Address
Mr. DERRICK JEROME JACKSON LLMSW
114 ORCHARD LAKE RD
PONTIAC, MI 48341-2244
Phone number: 248-858-7766