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1164295242
LISA ELAINE WILSON
TAHLEQUAH, OK
NPI
1164295242
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-11-01
Last Update Date
2023-11-01
Business Address
LISA ELAINE WILSON
1011 S MUSKOGEE AVE
TAHLEQUAH, OK 74464-4733
Phone number: 918-840-7047
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Mailing Address
LISA ELAINE WILSON
1011 S MUSKOGEE AVE
TAHLEQUAH, OK 74464-4733
Phone number: 918-840-7047
Copy
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