| NPI | 1023574829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE JONES Executive Administrator 314-872-1371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| 208000000X Pediatrics | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2019-02-16 |
| Last Update Date | 2019-06-28 |