Individual
KELLIE ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7010 S YALE AVE STE 215, TULSA, OK 74136-5743
(918) 492-2554
Mailing address
11006 S JAMES CT, JENKS, OK 74037-1663
(918) 949-0960
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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