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1770100604
MISTI DAWN JACKSON-HISE
POTEAU, OK
NPI
1770100604
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2020-06-26
Last Update Date
2020-06-26
Business Address
MISTI DAWN JACKSON-HISE
309 ROGERS AVE
POTEAU, OK 74953-4227
Phone number: 918-658-8078
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Mailing Address
MISTI DAWN JACKSON-HISE
PO BOX 3
TALIHINA, OK 74571-0003
Phone number: 918-413-1100
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