Individual
LATOYA KEYON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 NW 31ST ST, OKLAHOMA CITY, OK 73112-7407
(405) 848-7555
Mailing address
1605 NE EUCLID ST, OKLAHOMA CITY, OK 73117-2641
(405) 819-8920
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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