| NPI | 1033255039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATY BAIN Client Account Administrator 405-231-3817 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-02-11 |