Individual
WANA R. ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7777 E. HWY 66, EL RENO, OK 73036
(405) 651-3591
Mailing address
7777 E. HWY 66, EL RENO, OK 73036
(405) 651-3591
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/03/2009
Last updated
10/19/2011
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