| NPI | 1992210595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL DEATON Licensed Clinical Social Worker 918-694-5787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 6055) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |