Jackson, Deetra
Jackson, Deetra is an individual health care provider with primary practice located at 411 S Central Ave , Idabel OK 74745-6059. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Jackson, Deetra can be contacted via phone (580) 286-5045.Contact Information
Primary practice address
411 S Central Ave
Idabel OK 74745-6059
Phone: (580) 286-5045
Fax: (580) 286-5721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1326485582 |
|---|---|
| LBN Legal business name | Jackson, Deetra |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2013 |
| Last updated | May 29th, 2013 - about 11 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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