| NPI | 1093209660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL PHELPS Owner 918-742-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 966) |
| Additional Taxonomies | 251S00000X (Licence: OK 454) |
| 251S00000X (Licence: OK 860) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |