Tracy Lynn Jackson

NPI #1639611486 in Idabel, Oklahoma

Provider Information

NPI Number: 1639611486
Entity Type: Individual
Name: Tracy Lynn Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Nov 10, 2016
Last Updated: Nov 10, 2016

Practice Location

Address: 412 S CENTRAL AVE
City: Idabel
State: Oklahoma
ZIP Code: 74745-6060
Phone: (580) 286-6671

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