Jackie Ray Wilson is a Peer Specialist based in Tulsa, OK. Jackie Ray Wilson practices in Stroud, OK. The NPI Number for Jackie Ray Wilson is 1831835107 and holds a License No. (Oklahoma).
The current practice location address for Jackie Ray Wilson is 119 W 2Nd St, Stroud, OK and can be reached out via phone at 405-328-1549.
Location: 119 W 2Nd St, Stroud, OK, 74135-6106
Provider Profile Details
NPI Number
1831835107
Provider Name
Jackie Ray Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
119 W 2Nd St, Stroud, OK, 74135-6106
Phone Number
405-328-1549
Fax Number
Provider Enumeration Date
05/10/2022
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
119 W 2Nd St
City
State
Zip
74079-4011
Phone Number
405-328-1549
Fax Number
Provider Business Mailing Address Details
Address
119 W 2Nd St
City
State
Zip
74079-4011
Phone Number
405-328-1549
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
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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