| Gloria Jackson | |
|
220 W Congress St Fl 2 Detroit MI 48226-3289 | |
| (313) 963-4979 | |
| (313) 963-4997 |
| Full Name | Gloria Jackson |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 220 W Congress St Fl 2, Detroit, Michigan |
| Authorized Official Name and Position | Gloria Jackson (CEO) |
| Authorized Official Contact | 3139637949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria Jackson 220 W Congress St Fl 2 Detroit MI 48226-3289 Ph: (313) 963-4979 | Gloria Jackson 220 W Congress St Fl 2 Detroit MI 48226-3289 Ph: (313) 963-4979 |
| NPI Number | 1104915503 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104915503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801019214 (Michigan) | Primary |
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