Individual
SHRONDA L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3226
Mailing address
5011 S 76TH EAST AVE APT A, TULSA, OK 74145-6208
(918) 408-4387
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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