| NPI | 1043707847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZIE LEE LESTER Owner 314-477-6105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2005025550) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |