Individual
ILA NELL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-A
Contact information
Practice address
3400 NW 56TH ST, OKLAHOMA CITY, OK 73112-4463
(405) 949-1906
(405) 945-7189
Mailing address
3400 NW 56TH ST, OKLAHOMA CITY, OK 73112-4463
(405) 949-1906
(405) 945-7189
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
113
OK
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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