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1659585065
ALTROSIUS J JACKSON
DETROIT, MI
NPI
1659585065
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-09
Last Update Date
2007-07-08
Business Address
Ms. ALTROSIUS J JACKSON
8809 JOHN C. LODGE
DETROIT, MI 48202
Phone number: 313-887-6749
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Mailing Address
Ms. ALTROSIUS J JACKSON
8809 JOHN C. LODGE
DETROIT, MI 48202
Phone number: 313-887-6749
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