| NPI | 1346633864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE MINTZ Licensed Psychologist 573-808-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL PY8648) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |