| NPI | 1164791174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEA THON Instructor/Therapist 660-492-9072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |