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1841420346
NICOLE VANESSA JACKSON
LIVONIA, MI
NPI
1841420346
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Former Name
NICOLE VANESSA VAUGHN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801089011)
Enumeration Date
2009-07-17
Last Update Date
2022-07-11
Business Address
Mrs. NICOLE VANESSA JACKSON LMSW
39293 PLYMOUTH RD STE 109A
LIVONIA, MI 48150-1060
Phone number: 734-521-6579
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Mailing Address
Mrs. NICOLE VANESSA JACKSON LMSW
39293 PLYMOUTH RD SUITE 109A
LIVONIA, MI 48150-1060
Phone number: 734-521-6579
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