| NPI | 1245250091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDILBERTO B LORENZO Owner 417-777-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 33294) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 002181) |
| 1041C0700X Social Worker, Clinical (Licence: MO 20010000520) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-15475) | |
| 2084P0805X (Licence: AR R4566) | |
| 2084P0805X (Licence: TN 0000029442) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-09-25 |