| NPI | 1215697974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA COCHRAN Co Owner 314-620-9148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2022-04-13 |