Jackson, Amanda

Jackson, Amanda is an individual health care provider with primary practice located at 205 S Jt Stites , Sallisaw OK 74955-9301. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Jackson, Amanda can be contacted via phone (918) 775-7787.

Contact Information

Primary practice address
205 S Jt Stites Sallisaw OK 74955-9301
Phone: (918) 775-7787
Fax: (918) 775-0328
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1376041202
LBN Legal business name Jackson, Amanda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2018
Last updated Jan 25th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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