Individual
ANGELA MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCP, BHRS
Contact information
Practice address
2501 HUNTERS HILL DR, APT. 721, ENID, OK 73703-2311
(580) 231-1659
Mailing address
2501 HUNTERS HILL DR, APT. 721, ENID, OK 73703-2311
(580) 231-1659
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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