NPI | 1043109887 |
---|---|
Entity Type | Organization |
Authorized Contact | MCKINZIE DUESENBERG-MARSHALL Owner/Licensed Psychologist 314-960-4545 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2025-06-28 |
Last Update Date | 2025-06-28 |