| NPI | 1093090508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE TAYLOR Owner 573-619-9387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2004006930) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2013-11-19 |