Individual
WYLAN TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
2713 S HEMLOCK AVE, BROKEN ARROW, OK 74012-0818
(918) 851-2675
Mailing address
2713 S HEMLOCK AVE, BROKEN ARROW, OK 74012-0818
(918) 851-2675
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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