| NPI | 1275533853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRSHAD KHAN Administrator 314-843-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 00000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 00000) |
| 103T00000X Psychologist (Licence: MO 00000) | |
| 1041C0700X Social Worker, Clinical (Licence: MO 00000) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MO 00000) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2007-07-12 |