| NPI | 1508393042 |
|---|---|
| Former Name | TRACI DAWN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OK 0119242) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-05-15 |