Individual
WENDI POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 KIOWA ST, ARDMORE, OK 73401-2280
(580) 226-9388
Mailing address
1410 HOLLY LN, SULPHUR, OK 73086-1001
(580) 618-2001
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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