Tamara T Jackson
Counselor, Addiction (Substance Use Disorder) in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1164061073
StatusActive
Last updated in NPPESDec 26, 2019
Details
- NPI
- 1164061073
- Entity type
- Individual (NPI-1)
- Name
- Tamara T Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 26, 2019
- Certification date
- Dec 26, 2019
- Last updated
- Dec 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
40 Jefferson Ave SeGrand Rapids, MI 49503-4304
Phone 616-456-1443
Mailing address
40 Jefferson Ave SeGrand Rapids, MI 49503-4304
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All 68 Addiction (Substance Use Disorder) Counselor providers in Grand Rapids · All 20,987 providers in Grand Rapids
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