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1770920928
PHILLIP R JACKSON
SOUTHFIELD, MI
NPI
1770920928
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801033152)
Enumeration Date
2013-05-29
Last Update Date
2021-06-24
Business Address
Mr. PHILLIP R JACKSON Social Worker
26686 E CARNEGIE PARK DR
SOUTHFIELD, MI 48034-6151
Phone number: 248-728-4126
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Mailing Address
Mr. PHILLIP R JACKSON Social Worker
26686 E CARNEGIE PARK DR
SOUTHFIELD, MI 48034-6151
Phone number: 248-728-4126
Copy
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