Individual
LESLEY DAWN WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRSS
Contact information
Practice address
4238 NE 1ST ST, PRYOR, OK 74361-9614
(918) 825-1930
Mailing address
6503 W 415 RD, ADAIR, OK 74330-2854
(918) 638-4824
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/16/2021
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