| NPI | 1306357140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M PROST Licensed Professional Counselor 314-640-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MO 2011037455) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-03-17 |