Individual
JERI LYNN MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1420 N HARRISON AVE, SHAWNEE, OK 74801-5208
(405) 424-7711
Mailing address
935 SILVER CHASE DR, CHOCTAW, OK 73020-7176
(405) 634-4400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
11915
OK
101YM0800X
Mental Health Counselor
Primary
11915
OK
Other
Enumeration date
06/26/2023
Last updated
08/06/2024
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