Individual
MS. LILLIAN ANN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-0909
(918) 465-0404
Mailing address
311 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-0909
(918) 465-0404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
261QM0801X
OK
103TR0400X
Rehabilitation Psychologist
200471350A
OK
Other
Enumeration date
02/28/2013
Last updated
02/28/2013
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