| NPI | 1760919310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY R OGDEN Owner 580-220-7786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OK 3713) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OK 1-17-25192) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-05-15 |