| NPI | 1790148997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KAYE WALL CEO/Clinical Director 580-317-9140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 3499) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |