| NPI | 1154704534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KELLY MATZ Owner 417-894-4347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2015016664) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2015-07-03 |