| NPI | 1891812715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SHANIQUE SHOALS Executive Clinical Director 405-272-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 2664) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2020-08-22 |