| NPI | 1033805015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM HEWETT Administrative Assistant 918-207-9519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-04-13 |