Deetra Jackson

Counselor · Idabel, OK

Individual Active NPI

NPI number 1326485582

Practice location

411 S Central Ave
Idabel, OK 74745-6059
Phone
(580) 286-5045
Fax
(580) 286-5721

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NPI record

NPI
1326485582
Entity type
Individual (Type 1)
Enumeration date
May 29, 2013
Last updated
May 29, 2013
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Counselor Primary 101Y00000X — —

Mailing address

107 S High St
Antlers, OK 74523-3818
Phone
(580) 298-2830
Fax
(580) 298-6723

About Deetra Jackson

Deetra Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 411 S Central Ave, Idabel, OK 74745-6059. The NPI number 1326485582 was assigned on May 29, 2013 and the record was last updated on May 29, 2013.

Frequently asked questions

What is the NPI number of Deetra Jackson?

The NPI number is 1326485582.

What is the phone number of Deetra Jackson?

The phone number listed for the practice location is (580) 286-5045.

Where is Deetra Jackson located?

411 S Central Ave, Idabel, OK 74745-6059.

What is the taxonomy code for Deetra Jackson?

The primary taxonomy code is 101Y00000X – Counselor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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