Individual provider · Type 1 NPI
Elissa Nacole Jackson, RESIDENT ASSISTANT
Mental Health Counselor · Tulsa, OK
NPI number
1104587401
Active
Practice location
1719 E 27th St N
Tulsa, OK 74110-1705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1104587401
Elissa Nacole Jackson, RESIDENT ASSISTANT's National Provider Identifier is 1104587401, issued on Jan 7, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tulsa, OK. The record was last updated on Jan 7, 2022.