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1053730721
REGINA JACKSON
TULSA, OK
NPI
1053730721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-04-10
Last Update Date
2015-09-29
Business Address
-- REGINA JACKSON
6320 S 86TH E AVE APT B
TULSA, OK 74133
Phone number: 918-408-6390
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Mailing Address
-- REGINA JACKSON
8508 E 62ND ST APT F
TULSA, OK 74133-1935
Phone number: 918-934-8279
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