| NPI | 1689919482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALITHA SUSAN BACHMANN Member 918-369-4950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 3752) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 3728) |
| 106H00000X Marriage & Family Therapist (Licence: OK 982) | |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2017-11-27 |