| NPI | 1023432788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES P WOMACK Administrator 573-915-7986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 002712) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2022-01-24 |