Individual provider · Type 1 NPI

Roderick O. Jackson, C.P.S.S.

Addiction (Substance Use Disorder) Counselor · Highland Park, MI

NPI number 1801120779 Active

Practice location

211 Glendale St
Highland Park, MI 48203-3231

Mailing address

9176 Dixie
Redford, MI 48239-1516

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1801120779

Roderick O. Jackson, C.P.S.S.'s National Provider Identifier is 1801120779, issued on Sep 25, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Highland Park, MI. The record was last updated on Sep 25, 2009.