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General NPI Number Information
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NPI Number | 1356471908
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Entity Type | Individual
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Provider Name | VALERIE F JACKSON LMSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | G3163 FLUSHING RD SUITE 214
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City | FLINT
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State | MI
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Zip | 48504-4365
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Country | US
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Telephone | 810-845-6465
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Fax | 810-733-7317
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Provider Business Mailing Address
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Address Line | 5418 BRIGHT CREEK CT
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City | FLINT
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State | MI
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Zip | 48532-2254
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Country | US
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Telephone | 810-845-6465
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Fax | 810-733-7317
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801077180
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License Number State | MI
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