| NPI | 1023255106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB RUSSELL CONKLIN Owner, Lpc 417-627-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2025-11-11 |