| NPI | 1457657165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK FRANK TRACY Licensed Psychologist 405-213-6130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OK 1120) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2012-02-09 |