| NPI | 1811959398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BISHOP Medicaid Coordinator 918-341-5270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2020-08-22 |