Individual
MRS. KIMBERLY DEANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 J T STITES BLVD, SALLISAW, OK 74955-9323
(918) 315-1129
Mailing address
210 S JT STITES BLVD, SALLISAW, OK 74955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/20/2010
Last updated
05/19/2021
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