Heal Thyself Therapeutics, LLC

NPI #1003419136 in Milford, Michigan

Provider Information

NPI Number: 1003419136
Entity Type: Organization
Organization Name: Heal Thyself Therapeutics, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Nov 20, 2020
Last Updated: Dec 1, 2020

Practice Location

Address: 1100 CORPORATE OFFICE DR STE 320
City: Milford
State: Michigan
ZIP Code: 48381-5002
Phone: (810) 434-7933

Authorized Official

Name: MR. DERRICK JEROME JACKSON II, LMSW
Title: THERAPIST
Phone: (810) 434-7933

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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