| NPI | 1871346957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PILKERTON Biller 918-512-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-05-07 |