| NPI | 1225695653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY RAE JOHNSON Psychotherapist 918-688-5526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |