Individual
MS. WETAHANNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7901 NE 10TH ST STE B101, MIDWEST CITY, OK 73110-3653
(405) 250-8910
Mailing address
3057 OVERLAND DR, OKLAHOMA CITY, OK 73115-1815
(405) 754-9333
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/23/2020
Last updated
08/23/2020
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