| NPI | 1114011079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN MAYER Licensed Psychologist 573-443-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |