Individual
AMANDA WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 REPUBLIC ST, ARDMORE, OK 73401-4555
(580) 798-4421
Mailing address
1004 REPUBLIC ST, ARDMORE, OK 73401-4555
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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