Individual
LAKIA DAWN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
591 E 36TH ST N, TULSA, OK 74106-1812
(918) 619-4400
(918) 634-7884
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 619-4400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6712
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200668690A
—
OK
Enumeration date
10/12/2016
Last updated
10/22/2020
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