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Individual

MRS. FAYE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6901 SE 162ND ST, OKLAHOMA CITY, OK 73165-6849
(405) 210-7119
Mailing address
6901 SE 162ND ST, OKLAHOMA CITY, OK 73165-6849
(405) 210-7119

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
M000622408
OK

Other

Enumeration date
04/03/2017
Last updated
04/03/2017
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