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1891078671
CARL EDWARD JACKSON
ALTUS, OK
NPI
1891078671
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK 6694)
Enumeration Date
2011-09-28
Last Update Date
2020-10-08
Business Address
CARL EDWARD JACKSON M.S. LPC
120 W BROADWAY ST
ALTUS, OK 73521-3802
Phone number: 580-954-5966
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Mailing Address
CARL EDWARD JACKSON M.S. LPC
120 W BROADWAY ST
ALTUS, OK 73521-3802
Phone number: 580-954-5966
Copy
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