| NPI | 1215261219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY DUANE RANDLEMAN Psychologist 918-452-3512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 825) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |