| Skillz Boutique | |
|
25430 Southfield Rd Apt 102 Southfield MI 48075-1957 | |
| (248) 924-9644 | |
| Not Available |
| Full Name | Skillz Boutique |
|---|---|
| Speciality | Social Worker |
| Location | 25430 Southfield Rd Apt 102, Southfield, Michigan |
| Authorized Official Name and Position | Francine Jackson (OWNER) |
| Authorized Official Contact | 2489249644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skillz Boutique 25430 Southfield Rd Apt 102 Southfield MI 48075-1957 Ph: (248) 924-9644 | Skillz Boutique 25430 Southfield Rd Apt 102 Southfield MI 48075-1957 Ph: (248) 924-9644 |
| NPI Number | 1639868169 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/16/2023 |
| Medicare PECOS PAC ID | 8022477082 |
|---|---|
| Medicare Enrollment ID | O20230818002823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639868169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Francine L Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821546375 PECOS PAC ID: 0840532974 Enrollment ID: I20190422000159 |
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