| NPI | 1154922292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY VELICER Owner 314-467-0556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |