| NPI | 1013267392 |
|---|---|
| Former Legal Business Name | LAURA CHACKES PSY D LLC |
| Entity Type | Organization |
| Authorized Contact | LAURA CHACKES President 314-561-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2006027463) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2017-03-09 |