| NPI | 1205535358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE PETERSON Owner 816-533-5950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2026-03-10 |