| NPI | 1316218936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER B NOWAK Owner/Director 573-714-6855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 20110000573) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MO 2011008959) |
| 235Z00000X Speech-Language Pathologist (Licence: MO 2000174350) | |
| 235Z00000X Speech-Language Pathologist (Licence: MO 2006011487) | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-12-07 |