Individual provider · Type 1 NPI

Laqueta Jackson

Professional Counselor · Bixby, OK

NPI number 1740691666 Active

Practice location

7643 E 126th St S Ste 217D
Bixby, OK 74008-2988

Call (918) 280-9098 Map

Mailing address

5555 S Lewis Ave
Tulsa, OK 74105-7104

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Professional Counselor Primary 101YP2500X6994 (OK)

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About NPI 1740691666

Laqueta Jackson's National Provider Identifier is 1740691666, issued on May 13, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bixby, OK. The record was last updated on Jul 8, 2024.