| NPI | 1104609213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE WAKEFIELD VASSAR Psychiatrist 918-401-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |