| NPI | 1952714685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN POTTORF Counselor 918-852-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 1268) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |