| NPI | 1376134825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN LEA PREBYS Owner/Therapist 314-579-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |