Provider Demographics
NPI:1811264310
Name:PARKER-JACKSON, ASHLEY YVETTE (MA BHRS)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:YVETTE
Last Name:PARKER-JACKSON
Suffix:
Gender:F
Credentials:MA BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6418 N SANTA FE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-9130
Mailing Address - Country:US
Mailing Address - Phone:405-000-0000
Mailing Address - Fax:
Practice Address - Street 1:9804 CHESTERTON PL
Practice Address - Street 2:9804 CHESTERTON PLACE
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3611
Practice Address - Country:US
Practice Address - Phone:405-474-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)