| NPI | 1104446194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ELIZABETH STEVENSON MOORE Owner 314-606-1265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-05-11 |