| NPI | 1992367155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MANSOOR Owner 405-550-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |