| NPI | 1841655321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DYER Owner 918-984-9153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 4363) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2018-08-22 |