Individual
ASHLEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 N AIRPORT RD, WEATHERFORD, OK 73096-3351
(405) 424-7711
Mailing address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1399
OK
Other
Enumeration date
08/31/2016
Last updated
05/24/2021
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