Individual
DARLA DAWN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5208 W RENO AVE, OKLAHOMA CITY, OK 73127-6344
(405) 948-4800
Mailing address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
(405) 948-4933
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
919
OK
101YM0800X
Mental Health Counselor
Primary
4839
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200359107A
—
OK
Enumeration date
02/14/2011
Last updated
01/30/2024
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