| NPI | 1740636661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLA ROBERTSON Partner 918-973-0434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |