Individual
ELISSA NACOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RESIDENT ASSISTANT
Contact information
Practice address
1719 E 27TH ST N, TULSA, OK 74110-1705
(918) 982-7687
Mailing address
1719 E 27TH ST N, TULSA, OK 74110-1705
(918) 982-7687
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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