Individual
JENNIFER WRAY WISENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 S 5TH ST BLDG 4, HUGO, OK 74743-8013
(580) 372-0499
Mailing address
561 N 4250 RD, HUGO, OK 74743-3658
(580) 372-0499
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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