| NPI | 1346828050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MASON Owner 618-781-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 164W00000X Licensed Practical Nurse | |
| 207Q00000X Family Medicine | |
| 363A00000X Physician Assistant | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2022-12-02 |