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Michalla Jackson
Peer Specialist in Sand Springs, Oklahoma
NPI 1174279061

Michalla Jackson is a Peer Specialist based in Sand Springs, OK. Michalla Jackson practices in Sand Springs, OK. The NPI Number for Michalla Jackson is 1174279061 and holds a License No. (Oklahoma).

The current practice location address for Michalla Jackson is 602 Colony Dr, Sand Springs, OK and can be reached out via phone at 417-818-4821.

Location: 602 Colony Dr, Sand Springs, OK, 74063-1588
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174279061
Provider Name
Michalla Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
602 Colony Dr, Sand Springs, OK, 74063-1588
Phone Number
417-818-4821
Fax Number
Provider Enumeration Date
03/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
602 Colony Dr
City
Sand Springs
State
Oklahoma
Zip
74063-7428
Phone Number
417-818-4821
Fax Number
person
Provider Business Mailing Address Details
Address
602 Colony Dr
City
Sand Springs
State
Oklahoma
Zip
74063-7428
Phone Number
417-818-4821
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Oklahoma)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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