| NPI | 1528608676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE CREEK Member 816-210-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-05-13 |