| NPI | 1912113325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ERIC CARTER Cheif Executive Officer 405-414-7178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OK 102) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |