Organization
NATRUWELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAKERA JACKSON LPC (OWNER)
(405) 470-9355
Entity
Organization
Contact information
Practice address
1915 N MARTIN LUTHER KING AVE, OKLAHOMA CITY, OK 73111-1405
(405) 470-9355
Mailing address
1332 NE 5TH ST, OKLAHOMA CITY, OK 73117-2440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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