Individual
MRS. CRYSTEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4238 NORTHEAST 1ST, PRYOR, OK 74361
(918) 825-1930
Mailing address
4238 NORTHEAST 1ST, PRYOR, OK 74361
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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