| NPI | 1447772769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHRISTINE MAHANA Clinical Psychologist 417-838-3490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IN 20043022A) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-07-07 |