NPI 1184254401

Lenora Jackson

Practitioner Marriage & Family Therapist Detroit, MI

Practice location

Address: 18518 Saint Marys St, Detroit, MI 48235-2964
Phone: (313) 623-6235

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence 2136060208 (MI)

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Registry record

NPI: 1184254401
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Jan 2020
Record last updated: 12 Mar 2021

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.