| NPI | 1396593463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESS JOSLIN Insurance Credentialing Supervisor 918-766-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |