Individual
MARANDA FAYE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
(918) 560-1399
Mailing address
2325 S HARVARD AVE, TULSA, OK 74114-3300
(918) 991-6175
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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