| NPI | 1063965127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA I ROGERS Counselor 417-283-8391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.1600416) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |