Individual
ROBIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 W MAIN ST, ANTLERS, OK 74523-2059
(580) 209-6112
(580) 209-6159
Mailing address
194297 N 4230 RD, ANTLERS, OK 74523-7300
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OK
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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