| NPI | 1235679671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA STANLEY Owner 580-483-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 6222) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 6222) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |