Individual
PRISCILLA JACKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 W ARIES RD, EDMOND, OK 73003-5827
(405) 223-0457
Mailing address
1411 W ARIES RD, EDMOND, OK 73003-5827
(405) 223-0457
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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