Individual
MR. JIMMY A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TECH
Contact information
Practice address
221 2ND AVE NW, ARDMORE, OK 73401-6202
(580) 340-9187
(580) 226-3849
Mailing address
221 2ND AVE NW, ARDMORE, OK 73401-6202
(580) 340-9187
(580) 226-3849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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