Jacquline Jackson

NPI #1689943094 in Shawnee, Oklahoma

Provider Information

NPI Number: 1689943094
Entity Type: Individual
Name: Jacquline Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Enumeration Date: Dec 14, 2011
Last Updated: Mar 1, 2016

Practice Location

Address: 1127 N KICKAPOO AVE
City: Shawnee
State: Oklahoma
ZIP Code: 74801-4845
Phone: (405) 214-0116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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