| NPI | 1003173691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI LYNN OSBURN Executive Director 580-233-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-04-10 |