| NPI | 1295170363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE BASCOM Owner/ Lcsw 314-229-3483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2004031739) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2021-01-28 |