NPI | 1114658549 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVON OWEN Clinical Director, Clinician 405-740-1249 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2022-06-17 |
Last Update Date | 2023-01-26 |