| NPI | 1164896635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF PETERSON Counselor 816-866-5524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2011041053) |
| Enumeration Date | 2015-11-21 |
| Last Update Date | 2015-11-21 |