| NPI | 1639783012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON K BEETS Owner 918-752-4403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |