Individual
SARA LAFAWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. LPC
Contact information
Practice address
120 W BROADWAY ST, ALTUS, OK 73521-3802
(580) 649-8355
(580) 379-4010
Mailing address
120 W BROADWAY ST, ALTUS, OK 73521-3802
(580) 649-8355
(580) 649-8355
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
4704
OK
Other
Enumeration date
05/26/2010
Last updated
09/14/2020
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