Individual
MARTHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. PSYCHOLOGY
Contact information
Practice address
1604 N WASHINGTON AVE, DURANT, OK 74701-2128
(580) 513-4067
Mailing address
2220 WILSON ST, DURANT, OK 74701-5517
(580) 230-8828
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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