NPI | 1205613247 |
---|---|
Entity Type | Organization |
Authorized Contact | MARQUITTA FRAZIER Credentialing Specialist 405-425-0442 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2023-09-13 |
Last Update Date | 2023-09-13 |