| NPI | 1083037956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FREDERICK Executive Director 918-893-3735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OK 2767) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities | |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2018-03-17 |