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1174279061
MICHALLA JACKSON
SAND SPRINGS, OK
NPI
1174279061
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2022-03-01
Last Update Date
2022-03-01
Business Address
MICHALLA JACKSON
602 COLONY DR
SAND SPRINGS, OK 74063-7428
Phone number: 417-818-4821
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Mailing Address
MICHALLA JACKSON
PO BOX 1588
SAND SPRINGS, OK 74063-1588
Phone number: 417-818-4821
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