| NPI | 1174290225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA JAYE CAPRETTO Manager/Licensed Psychologist 918-949-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-08-26 |