| NPI | 1063500494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WINTERS Business Manager 314-289-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2006031019) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-10-15 |