| NPI | 1497353171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA A SHAUGHNESSY Counselor 314-275-0617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2021-07-25 |