Organization
PSACMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYNONA ANN WILDER (ADM ASST)
(405) 520-8336
Entity
Organization
Contact information
Practice address
2611 N MLK AVE, OKLAHOMA CITY, OK 73111-3313
(405) 424-2600
Mailing address
2611 N MLK AVE, OKLAHOMA CITY, OK 73111-3313
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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