| NPI | 1447231808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE JEAN DOMSCH Licensed Clinical Social Worker 417-272-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO MO 004512) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO MO 004512) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2016-05-13 |