| NPI | 1790246619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M FISHER CEO 918-268-9578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 101YM0800X Counselor, Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-02-09 |