Individual
MR. NATHAN RAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.M.A.
Contact information
Practice address
804 W CHOCTAW AVE, CHICKASHA, OK 73018-2310
(405) 222-0622
Mailing address
4825 BISMARC DR, DEL CITY, OK 73115-4413
(405) 208-8753
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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