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1285933176
KIM MARIE JACKSON
WAGONER, OK
NPI
1285933176
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2011-03-18
Last Update Date
2011-03-18
Business Address
Mrs. KIM MARIE JACKSON
2109 S HIGHWAY 69
WAGONER, OK 74467-9310
Phone number: 918-485-0242
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Mailing Address
Mrs. KIM MARIE JACKSON
2109 S HIGHWAY 69
WAGONER, OK 74467-9310
Phone number: 918-485-0242
Copy
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