Individual
PATRICIA ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5116 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2077
(405) 943-7500
Mailing address
1824 RIDGEWAY DR, YUKON, OK 73099-5631
(405) 626-2191
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/10/2009
Last updated
11/03/2010
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