Derisha Jackson
Derisha Jackson is a Counselor in Midwest City, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2011.
- In the registry since
- 2011
Practice location Address checks out
351 N Air Depot Blvd Ste SMidwest City, OK 73110-1700
Phone: (405) 610-6540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1780968628 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | October 10, 2011 |
| Last updated in NPPES | October 10, 2011 |
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