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Latrice Vernice Jackson
Mental Health Counselor in Shawnee, Oklahoma
NPI 1275800997

Latrice Vernice Jackson is a Mental Health Counselor based in Shawnee, OK and is specialized in Mental Health. Latrice Vernice Jackson practices in Shawnee, OK. The NPI Number for Latrice Vernice Jackson is 1275800997 and holds a License No. (Oklahoma).

The current practice location address for Latrice Vernice Jackson is 1415 E 10Th St, Shawnee, OK and can be reached out via phone at 405-382-7623.

Location: 1415 E 10Th St, Shawnee, OK, 74801-7801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275800997
Provider Name
Latrice Vernice Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1415 E 10Th St, Shawnee, OK, 74801-7801
Phone Number
405-382-7623
Fax Number
Provider Enumeration Date
11/23/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1415 E 10Th St
City
Shawnee
State
Oklahoma
Zip
74801-7801
Phone Number
405-382-7623
Fax Number
person
Provider Business Mailing Address Details
Address
1415 E 10Th St
City
Shawnee
State
Oklahoma
Zip
74801-7801
Phone Number
405-382-7623
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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