| NPI | 1275974842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI LIN FORTNER Licensed Professional Counselor 636-667-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2010013715) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |