| NPI | 1487009361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY S MARTIN Owner/Therapist 660-232-1107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2011024378) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |