| NPI | 1205598877 |
|---|---|
| Other Name | JACQUELINE BONTRAGER |
| Entity Type | Organization |
| Authorized Contact | MISSY TRENTHAM Office Manager 918-749-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2021-10-11 |