| NPI | 1427140219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN GANT WARD Director 405-735-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-01-14 |