| NPI | 1477360600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAITTON NICOLE KENDRICK CALLERY Owner/Solo Practitioner 918-658-8352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2025-01-07 |