| NPI | 1083173520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA LACKAYE Owner / Therapist 573-356-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |