Individual
SELENA LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7718 MILLSTONE TRAIL LN # NA, RICHMOND, TX 77469-3757
(832) 558-1409
Mailing address
PO BOX 44, OKMULGEE, OK 74447-0044
(713) 865-6787
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
63815
TX
104100000X
Social Worker
9115
OK
Other
Enumeration date
11/23/2023
Last updated
08/07/2024
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