Individual
SARA WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2552 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 893-3735
Mailing address
2552 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 893-3735
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5008
OK
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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