Individual
MRS. CHRISTY DAWN CHILDRESS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
12270 N 345 RD, BOYNTON, OK 74422-4401
(918) 261-3554
Mailing address
PO BOX 485, HASKELL, OK 74436-0485
(918) 261-3554
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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