Individual
WILDINE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 W MAIN ST # 1032, OKLAHOMA CITY, OK 73102-2221
(405) 417-7801
Mailing address
623 W MAIN ST # 1032, OKLAHOMA CITY, OK 73102-2221
(405) 417-7801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
03/21/2026
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