Individual
JESSICA ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 LYNNWOOD ST, DURANT, OK 74701-2919
(580) 924-6263
(580) 924-6775
Mailing address
1105 LYNNWOOD ST, DURANT, OK 74701-2919
(580) 924-6263
(580) 924-6775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
08/21/2008
Last updated
05/20/2010
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