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1316393796
SHAWN PIERRE JACKSON
TULSA, OK
NPI
1316393796
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK 1023172897)
Enumeration Date
2016-05-04
Last Update Date
2016-05-04
Business Address
-- SHAWN PIERRE JACKSON
3242 S LAKEWOOD AVE 2F
TULSA, OK 74135-4910
Phone number: 918-402-0749
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Mailing Address
-- SHAWN PIERRE JACKSON
3242 S LAKEWOOD AVE 2F
TULSA, OK 74135-4910
Phone number: 918-402-0749
Copy
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