CORNELL LEE JACKSON

DETROIT, MI
NPI1851630461
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2013-02-04
Last Update Date2013-02-04
Business Address
Mr. CORNELL LEE JACKSON
1852 W GRAND BLVD
DETROIT, MI 48208-1006
Phone number: 313-894-8444
Mailing Address
Mr. CORNELL LEE JACKSON
1852 W GRAND BLVD
DETROIT, MI 48208-1006
Phone number: 313-894-8444
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