| NPI | 1255459889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MICHELE LAGRAND Sole Proprietor 918-931-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OK 727) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AR 04-1P) |
| 103TC0700X Psychologist Clinical (Licence: AK 533) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |