| NPI | 1144686767 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KELLEY BRONNELL BLAIR Licensed Professional Counselor 405-761-7402 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 5944) | 
| Enumeration Date | 2016-01-12 | 
| Last Update Date | 2016-09-07 |