| NPI | 1063163442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON BRIAUNA SHELBY Owner/Psychologist 618-727-1913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |