Individual
ILINDA KYLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 N HUDSON AVE, OKLAHOMA CITY, OK 73103-3918
(405) 272-0660
(405) 272-1596
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
(405) 858-2720
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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