Individual
MRS. ITAI CHINHAMO-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC CANDIDATE
Contact information
Practice address
1802 NW FERRIS AVE, LAWTON, OK 73507-5625
(580) 585-4200
Mailing address
905 NE ROGERS LN APT 1, LAWTON, OK 73507-1735
(803) 807-8998
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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