| NPI | 1285388140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MICHELLE JACKSON Owner & Licensed Professional Thera 580-231-1659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |