Individual
ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2603 S 15TH PL, BROKEN ARROW, OK 74012-7285
(918) 251-7199
(539) 777-2501
Mailing address
PO BOX 1678, BROKEN ARROW, OK 74013-1678
(918) 251-7199
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5714
OK
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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