Individual
MS. WYNEMA MARIE RA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
6404 WESTLANE, OKLAHOMA CITY, OK 73142-4420
(405) 720-2476
Mailing address
6404 WESTLANE, OKLAHOMA CITY, OK 73142-4420
(405) 720-2476
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
260
OK
101YP2500X
Professional Counselor
Primary
2692
OK
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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