| NPI | 1366682692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L DAVIS Owner 573-584-0158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 000949) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2002006736) |
| 103TC0700X Psychologist Clinical (Licence: MO 01459) | |
| 1041C0700X Social Worker Clinical (Licence: MO 2008019098) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2009-02-26 |