| NPI | 1316196405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA BURNSIDE Lcsw 580-436-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK LCSW) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2008-09-12 |