| NPI | 1487008736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE M MENTZER Managing Member 405-201-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 5444) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |