| NPI | 1063903839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA BETH HURST Clinical Mental Health Therapist 918-916-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2018-05-28 |