Individual
MRS. DEADRA KAY WYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 W 106TH ST S, JENKS, OK 74037-1627
(918) 693-2538
Mailing address
3712 W 106TH ST S, JENKS, OK 74037-1627
(918) 693-2538
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Enumeration date
08/22/2014
Last updated
05/23/2016
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