| NPI | 1124560420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNA HALCOMB Counselor 918-808-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 4203) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2016-11-17 |