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Jimmy Jackson, TECH
NPI 1376836957 · on the registry since 2011 · sole proprietor
Practice
- Address
- 221 2nd Ave Nw
Ardmore, OK 73401 - Phone
- (580) 340-9187
- Fax
- (580) 226-3849
- Organisation at this address
- Broadway House, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Mental Health Counselor
101YM0800X
- Sex
- Male
- Record last updated
- 2011-05-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma