Provider Demographics
NPI:1174838171
Name:WILSON, MARGARET LOUISE (MED)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:LOUISE
Last Name:WILSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 E RENO AVE APT 810
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-2011
Mailing Address - Country:US
Mailing Address - Phone:254-931-3116
Mailing Address - Fax:
Practice Address - Street 1:6000 E RENO AVE APT 810
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2011
Practice Address - Country:US
Practice Address - Phone:254-931-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)