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1760899744
KIYYO SHIRESE JACKSON
DETROIT, MI
NPI
1760899744
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: MI 6803086048)
Enumeration Date
2014-07-22
Last Update Date
2014-07-22
Business Address
-- KIYYO SHIRESE JACKSON
2925 RUSSELL ST
DETROIT, MI 48207-4825
Phone number: 313-396-5300
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Mailing Address
-- KIYYO SHIRESE JACKSON
2925 RUSSELL ST
DETROIT, MI 48207-4825
Phone number: 313-396-5300
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