| NPI | 1669913117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMALI FERNANDO Clinical Psychologist 405-242-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 1214) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |