| NPI | 1518319276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN G WARD Owner/Director 405-735-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OK 1011) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |