| NPI | 1497368245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRSITINA MARIE CONRAD Executive And Clinical Director 918-694-6606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2020-08-30 |