Tyra Lee Wilson

NPI #1336868710 in Wagoner, Oklahoma

Provider Information

NPI Number
1336868710
Entity Type
Individual
Name
Tyra Lee Wilson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Case Management
Enumeration Date
Aug 26, 2022
Last Updated
Aug 26, 2022

Practice Location

Address
109 S HARRILL AVE
ZIP Code
74467-5317
Phone
(918) 485-0242

Specialties & Taxonomy Codes

Specialty
Case Management

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