| NPI | 1518211747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M BENTON Psychologist 918-392-4866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 1057) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |