| NPI | 1063903425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL UTHOFF Vice President 314-307-1307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 27619) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |