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NPI Code Detail

MEDICARE: ANGEL L WILSON MS, LMFT

MEDICARE: ANGEL L WILSON MS, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist11923OK

General Provider Information

NPI Number : 1679262257
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEL L WILSON MS, LMFT
Provider Business Mailing Address
First Line : 201 NE 50TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-1811
Country : US
Telephone Number : 405-235-7537
Fax Number :
Provider Business Practice Location Address
First Line : 201 NE 50TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-1811
Country : US
Telephone Number : 405-235-7537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2023
Last Update Date : 01/12/2026

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Directions to “ ANGEL L WILSON MS, LMFT” Practice Location

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