| NPI | 1225570880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BETH O'DONNELL Licensed Clinical Social Worker 314-643-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2015039713) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |