Individual provider · Type 1 NPI
Kevin Thomas Jackson
Mental Health Counselor · Tulsa, OK
NPI number
1114456498
Active
Practice location
310 S 49th W Ave
Tulsa, OK 74127
Mailing address
310 S 49th West Ave
Tulsa, OK 74127-7619
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 1114456498
Kevin Thomas Jackson's National Provider Identifier is 1114456498, issued on Jun 8, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tulsa, OK. The record was last updated on Jun 8, 2017.