| NPI | 1053851543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA DOLL Owner 405-641-1084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 6192) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 6192) |
| 101YP2500X Counselor, Professional (Licence: OK 6192) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |