| NPI | 1821211087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WILSON Clinical Social Worker 918-343-3456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 1175) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2009-09-10 |