| NPI | 1427358696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM BOWMAN Hr 573-214-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO PY01793) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2009031585) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2010018200) | |
| 1041C0700X Social Worker, Clinical (Licence: MO 2003027880) | |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2023-01-25 |