| NPI | 1174209423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA COPPEDGE Co Owner 417-413-1470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-07-25 |