Individual
TALESA DAMARIZ WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
416 S MUSTANG RD STE B, YUKON, OK 73099-7314
(405) 254-7746
Mailing address
2307 N THOMPKINS AVE APT S5, BETHANY, OK 73008-5334
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
OK
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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