| NPI | 1417508904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA L CORNWELL Ph D And Owner 918-708-9558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |