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Terry Allen Wilson
Peer Specialist in Wyandotte, Oklahoma
NPI 1306500905

Terry Allen Wilson is a Peer Specialist based in Wyandotte, OK. Terry Allen Wilson practices in Wyandotte, OK. The NPI Number for Terry Allen Wilson is 1306500905 and holds a License No. (Oklahoma).

The current practice location address for Terry Allen Wilson is 10025 S 705 Rd, Wyandotte, OK and can be reached out via phone at 918-303-5433.

Location: 10025 S 705 Rd, Wyandotte, OK, 74370-9507
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306500905
Provider Name
Terry Allen Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
10025 S 705 Rd, Wyandotte, OK, 74370-9507
Phone Number
918-303-5433
Fax Number
Provider Enumeration Date
10/29/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
301450 01 OK STUDENT
institution
Provider Business Practice Location Address Details
Address
10025 S 705 Rd
City
Wyandotte
State
Oklahoma
Zip
74370-9507
Phone Number
918-303-5433
Fax Number
person
Provider Business Mailing Address Details
Address
10025 S 705 Rd
City
Wyandotte
State
Oklahoma
Zip
74370-9507
Phone Number
918-303-5433
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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