Individual
MR. CHARLES LYNN WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1402 N FLORENCE AVE STE B, CLAREMORE, OK 74017-3159
(918) 608-0380
(209) 425-5727
Mailing address
1402 N FLORENCE AVE STE B, CLAREMORE, OK 74017-3159
(186) 080-3809
(209) 425-5727
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10690
OK
Other
Enumeration date
06/25/2017
Last updated
04/12/2022
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