| NPI | 1306394663 |
|---|---|
| Doing Business As | LAUREN DEISENROTH PMHNP-BC |
| Entity Type | Organization |
| Authorized Contact | LAUREN KATHERINE DEISENROTH Pmhnp, Owner 918-520-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |