| NPI | 1316458441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL A CLINE Owner 417-414-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MO 2010006114) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2022-01-04 |