Jackson, Latoya Nichole
Jackson, Latoya Nichole is an sole proprietor health care provider with primary practice located at 1717 W 33Rd St , Edmond OK 73013-3819. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Jackson, Latoya Nichole can be contacted via phone (405) 216-5608.Contact Information
Primary practice address
1717 W 33Rd St
Edmond OK 73013-3819
Phone: (405) 216-5608
Fax: (405) 216-5272
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X |
Profile Details
| NPI number | 1497057442 |
|---|---|
| LBN Legal business name | Jackson, Latoya Nichole |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 24th, 2010 |
| Last updated | Nov 24th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497057442 | NPPES |
| Oklahoma | MEDICAID | 200123000A |
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