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1780968628
DERISHA JACKSON
MIDWEST CITY, OK
NPI
1780968628
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2011-10-10
Last Update Date
2011-10-10
Business Address
-- DERISHA JACKSON
351 N AIR DEPOT BLVD SUITE S
MIDWEST CITY, OK 73110-1700
Phone number: 405-610-6540
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Mailing Address
-- DERISHA JACKSON
13525 N HOLLOW ROCK RD. APT D
OKLAHOMA CITY, OK 73120
Phone number: 209-242-4270
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