Individual
MS. ANGELA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
551 N 28TH WEST AVE, TULSA, OK 74127-6139
(918) 794-0197
(918) 794-0196
Mailing address
551 N 28TH WEST AVE, TULSA, OK 74127-6139
(918) 794-0197
(918) 794-0196
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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