| NPI | 1356627020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD WESLEY WALDEN Member 573-221-3356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| 102L00000X Psychoanalyst | |
| 103K00000X Behavior Analyst | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 1041S0200X Social Worker, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |