Individual provider · Type 1 NPI

Tera Jackson

Mental Health Clinic/Center (Including Community Mental Health Center) · Edmond, OK

NPI number 1699045104 Active

Practice location

3109 Stone Hill Trl
Edmond, OK 73034-6180

Call (405) 812-4692 Map

Mailing address

1512 Patricia Dr
Midwest City, OK 73130-1637

Specialties and licenses

TaxonomyCodeLicense
Mental Health Clinic/Center (Including Community Mental Health Center) Primary 261QM0801XNone listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

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About NPI 1699045104

Tera Jackson's National Provider Identifier is 1699045104, issued on Jan 1, 2012. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Edmond, OK. The record was last updated on Aug 7, 2024.