| NPI | 1306455068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY W NEWBERRY Lpc Supervisor 405-812-0197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |