Individual
ALICIA ELAINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1040 SW 4TH ST, MOORE, OK 73160-2405
(405) 736-8478
Mailing address
1040 SW 4TH ST, MOORE, OK 73160-2405
(405) 735-8478
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4117
OK
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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