| NPI | 1619441680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE KESTERSON-CRAVENS Psychologist 918-527-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2022-04-05 |