| NPI | 1568110542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE SPERRY Licensed Professional Counselor 405-255-5982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-04-08 |