| NPI | 1366779100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA S. FUGE Psychologist 417-924-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2005028862) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2009-12-14 |