| NPI | 1538473392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY JACKSON Director 417-569-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2008004542) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2010-08-03 |