Doctor Name: | MARQUITA RENEE WILSON |
NPI Number: | 1154672780 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1 W 36th St N Tulsa, OK - 741061700 |
Business Phone Number: | 9186364165 |
Business Fax Number: | |
Mailing Address: | 2417 E 48th St N, TULSA |
State: | OK |
Postal Code: | 741302017 |
Phone Number: | 9186364165 |
Fax Number: | |
NPI Enumeration Date: | 09/22/2012 |
NPI Last Update Date: | 09/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |