| NPI | 1588725295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEATISHA R DUBOSE Office Manager 580-351-0242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OK 789) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 562) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |