| NPI | 1205959210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY DIBENEDETTO Owner 573-875-1576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 000222) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-01-20 |