Healthcare Provider Details
I. General information
NPI: 1821928623
Provider Name (Legal Business Name): WILDFLOWER PSYCHOLOGY & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11401 E 101ST ST N
OWASSO OK
74055-6421
US
IV. Provider business mailing address
3171 S 129TH E AVE STE A #5298
TULSA OK
74134
US
V. Phone/Fax
- Phone: 918-236-8133
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AMBER
NIPPER
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 918-236-8133