| NPI | 1952881427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PETTY Lpc And Owner 918-212-6196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 5565) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |