SHANTANIQUE JACKSON
Social Worker - Clinical
Active
Individual
NPI: 1396310595
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Social Worker - Clinical | 1041C0700X | Yes | 6801119838 (MI) |
Frequently Asked Questions
NPI 1396310595 is the National Provider Identifier for SHANTANIQUE JACKSON, a Social Worker - Clinical provider located in Detroit, MI. This NPI was enumerated on May 21, 2021.
SHANTANIQUE JACKSON practices at 24306 CHIPPEWA ST, Detroit, MI 48219.
Quick Facts
- NPI
- 1396310595
- Type
- Individual
- Enumerated
- May 21, 2021
- Last Updated
- Mar 11, 2025
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