| NPI | 1174919351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY CORMIER Director 618-453-2361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 1041C0700X Social Worker, Clinical | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |