| NPI | 1114341609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE MILLER Provider 405-641-7549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |