| NPI | 1982923314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS ASHLEY GRANT Lmft Candidate 580-284-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 1201) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2016-06-15 |