| NPI | 1376821892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CARTER FAIRMAN Licensed Psychologist 417-437-3244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2004033756) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2013-02-01 |