| NPI | 1144428137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MICHELLE JENNINGS Physician 636-484-0632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2004001640) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2010-09-22 |