Decarlo-Jackson, Tanja

Decarlo-Jackson, Tanja is an individual health care provider with primary practice located at 1400 E 12 Mile Rd , Madison Heights MI 48071-2651. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Decarlo-Jackson, Tanja can be contacted via phone (248) 547-2223.

Contact Information

Primary practice address
1400 E 12 Mile Rd Madison Heights MI 48071-2651
Phone: (248) 547-2223
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X Michigan

Profile Details

NPI number 1073722161
LBN Legal business name Decarlo-Jackson, Tanja
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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