| NPI | 1639802127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SUSAN KUNKEL Owner 405-713-5792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2022-07-24 |