| NPI | 1497022321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LIGHTLE Mbr 573-822-4306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2006025673) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2011-11-21 |