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 |