| NPI | 1679302632 |
|---|---|
| Other Name | SHANNON KATHLEEN MARIE THUMANN |
| Entity Type | Organization |
| Authorized Contact | SHANNON KATHLEEN MARIE THUMANN Owner 918-815-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-10-18 |