| NPI | 1932144797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ERNEST SHADID Owner 405-579-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |