Individual
BRANDY NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, BHRS
Contact information
Practice address
112 N MCKINLEY, CHANDLER, OK 74834
(405) 258-3043
Mailing address
PO BOX 202, 209 W CENTRAL, CARNEY, OK 74832
(405) 258-8053
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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