Individual
MS. LATOSHA MARTHIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2619 N HARVEY AVE, OKLAHOMA CITY, OK 73103
(405) 525-3959
(405) 525-3439
Mailing address
2619 N HARVEY AVE, OKLAHOMA CITY, OK 73103-3017
(405) 525-3959
(405) 525-3439
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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