Individual
KELLI WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBS
Contact information
Practice address
221 RIDGECREST DR, CALERA, OK 74730-2510
(580) 924-6363
(580) 924-0379
Mailing address
221 RIDGECREST DR, CALERA, OK 74730-2510
(580) 924-6363
(580) 924-0379
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2732
OK
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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