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1902110505
MICHELL RENEE WILSON
CHICKASHA, OK
NPI
1902110505
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-08-06
Last Update Date
2010-08-06
Business Address
Mrs. MICHELL RENEE WILSON M.S.
1309 S 13TH ST
CHICKASHA, OK 73018-4248
Phone number: 405-224-7860
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Mailing Address
Mrs. MICHELL RENEE WILSON M.S.
1309 S 13TH ST
CHICKASHA, OK 73018-4248
Phone number: 405-224-7860
Copy
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