| NPI | 1558852566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH BRESEKE Owner 573-639-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0004992) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CO 0004992) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |