NPI 1023523479

Jacqueline Denise Douglas

Practitioner Contractor Detroit, MI

Practice location

Address: 1121 E McNichols Rd, Detroit, MI 48203-2857
Phone: (616) 365-3100
Fax: (313) 365-3098

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1023523479
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Dec 2017
Record last updated: 7 Dec 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.