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1023212891
JACKIE L. SHAW
EDMOND, OK
NPI
1023212891
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Former Name
JACKIE L WHITE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK LPC #1123, LMFT#655)
Enumeration Date
2007-06-13
Last Update Date
2016-07-27
Business Address
Mrs. JACKIE L. SHAW M.Ed,, LPC, LMFT
307 E DANFORTH RD SUITE 118
EDMOND, OK 73034-4483
Phone number: 405-285-4700
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Mailing Address
Mrs. JACKIE L. SHAW M.Ed,, LPC, LMFT
PO BOX 755
CRESCENT, OK 73028-0755
Phone number: 405-550-1038
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