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1871049684
MONIQUE JACKSON
DETROIT, MI
NPI
1871049684
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XG0600X Occupational Therapist, Gerontology
(Licence: MI 5202005667)
Enumeration Date
2016-08-31
Last Update Date
2016-08-31
Business Address
-- MONIQUE JACKSON
21630 JESSEL AVE
DETROIT, MI 48219
Phone number: 855-213-9980
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Mailing Address
-- MONIQUE JACKSON
5460 WOODLAND RIDGE DR
FLINT, MI 48532-2271
Phone number:
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