Lori Lyn Wilson

NPI #1427665660 in Mustang, Oklahoma

Provider Information

NPI Number: 1427665660
Entity Type: Individual
Name: Lori Lyn Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Sep 30, 2020
Last Updated: Sep 30, 2020

Practice Location

Address: 12700 SW 53RD ST
City: Mustang
State: Oklahoma
ZIP Code: 73064-7257
Phone: (405) 503-1073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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