Individual
MR. DESMOND WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
COUNSELOR
OK
Enumeration date
05/22/2009
Last updated
05/22/2009
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