Individual
MS. CICELY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1516 S BOSTON AVE, 100, TULSA, OK 74119-4003
(918) 933-5628
Mailing address
1516 S BOSTON AVE, TULSA, OK 74119-4003
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/13/2010
Last updated
01/25/2010
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