| NPI | 1376713933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWIN STEWAART Owner 314-724-0503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MO 2002011104) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |