| NPI | 1992330666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY DANE NALL Owner 405-400-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2023-08-17 |