| NPI | 1437651908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY RENEE LAWELLIN Counselor 580-334-6167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 987) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 987) |
| 101YM0800X Counselor, Mental Health (Licence: OK 987) | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |