NPI | 1316255789 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRI T SLACK Owner 405-401-1464 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4164) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 638) |
Enumeration Date | 2010-09-20 |
Last Update Date | 2010-09-20 |