| NPI | 1689213936 |
|---|---|
| Doing Business As | PAM FORDUCEY, PHD |
| Entity Type | Organization |
| Authorized Contact | PAM FORDUCEY President 405-550-3482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2020-01-04 |