| NPI | 1285026658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA M NICKLE Owner 417-812-4866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 200011708990) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2016-04-20 |