| NPI | 1073567491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY JANE BOECKMANN Director Of Administrative Services 573-751-4055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 103TC0700X Psychologist Clinical | |
| 208D00000X General Practice | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-10-27 |