| NPI | 1184745176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE JEAN BURROUGH Owner 580-436-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 1805) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-23 |