| NPI | 1104173590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA BASS Counselor 314-537-7747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO cs001120) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |