| NPI | 1528476967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY ELLEGARD Owner/Clinician 405-229-9514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 5259) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-08-05 |