Elizabeth Marie Jackson
Psychologist
43155 Main St Atrium 2300 Suite I
Novi
, Michigan 48375-1777
Elizabeth Marie Jackson
Psychologist
43155 Main St Atrium 2300 Suite I
Novi
, Michigan 48375-1777
(734) 770-9070
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About
Features
Specialties
- Psychologist
Languages spoken
- English
Location
First Address
- Elizabeth Marie Jackson
- 8566 Cadillac Cir
- Grosse Ile, MI
- Zip : 48138-2216
- Phone : (734) 770-9070
Second Address
- Elizabeth Marie Jackson
- 43155 Main St Atrium 2300 Suite I
- Novi, MI
- Zip : 48375-1777
- Phone : (734) 656-8191
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | 6301016009 | MI |
| Y | 103T00000X | Psychologist | 6301016009 | MI |
National Provider Identifier
| NPI | 1013373240 |
|---|---|
| Provider Name | Elizabeth Marie Jackson |
| First Address | Grosse Ile, MI 48138-2216 |
| Second Address | Novi, MI 48375-1777 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2016 |
| Last Update Date | 17/05/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.