Individual
JASMINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13600 E 86TH ST N STE 100, OWASSO, OK 74055-8732
(918) 272-9313
(918) 403-6311
Mailing address
13600 E 86TH ST N STE 100, OWASSO, OK 74055-8732
(918) 272-9313
(918) 403-6311
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/29/2013
Last updated
01/31/2019
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