Individual
JASON LYN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, LPC
Contact information
Practice address
201 N 14TH ST, FREDERICK, OK 73542-5829
(405) 833-0680
Mailing address
201 N 14TH ST, FREDERICK, OK 73542-5829
(405) 833-0680
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3985
OK
Other
Enumeration date
10/01/2008
Last updated
09/02/2009
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