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1104587401
ELISSA NACOLE JACKSON
TULSA, OK
NPI
1104587401
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-01-07
Last Update Date
2022-01-07
Business Address
ELISSA NACOLE JACKSON Resident Assistant
1719 E 27TH ST N
TULSA, OK 74110-1705
Phone number: 918-982-7687
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Mailing Address
ELISSA NACOLE JACKSON Resident Assistant
1719 E 27TH ST N
TULSA, OK 74110-1705
Phone number: 918-982-7687
Copy
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