Individual provider · Type 1 NPI
Phil Leodis Jackson Jr.
Mental Health Counselor · Oklahoma City, OK
NPI number
1972847937
Active
Practice location
2769 NW 16th St
Oklahoma City, OK 73107-4843
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 1972847937
Phil Leodis Jackson Jr.'s National Provider Identifier is 1972847937, issued on Nov 15, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oklahoma City, OK. The record was last updated on Nov 15, 2012.