Individual
RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
PH. D., LPC-S
Contact information
Practice address
12742 E 22ND ST, TULSA, OK 74129-6004
(951) 892-9349
Mailing address
12742 E 22ND ST, TULSA, OK 74129-6004
(951) 892-9349
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7082
OK
Other
Enumeration date
07/10/2020
Last updated
02/18/2025
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