Individual
ERICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3200
(918) 560-1399
Mailing address
706 E 34TH ST N, TULSA, OK 74106-1920
(918) 221-4918
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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