| NPI | 1366076341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA RAE NGOTNGAMWONG Owner/Psychotherapist 918-268-6379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |