Individual
MS. SHEREE ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6202 S LEWIS AVE, TULSA, OK 74136-1099
(918) 949-4086
Mailing address
12123 N 108TH EAST AVE, COLLINSVILLE, OK 74021-5548
(972) 345-1143
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
OK
Enumeration date
09/05/2012
Last updated
09/05/2012
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