Provider Demographics
NPI:1881138980
Name:WESSINGER, CECILIA
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:WESSINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 E 38TH ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-3351
Mailing Address - Country:US
Mailing Address - Phone:918-630-3593
Mailing Address - Fax:
Practice Address - Street 1:9726 E 42ND ST
Practice Address - Street 2:#124
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3652
Practice Address - Country:US
Practice Address - Phone:918-640-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator