| NPI | 1982152948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMINA LONG Owner/Lpc 405-249-3386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 72046) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |