| NPI | 1568972107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDA L HERRON Owner 573-591-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2013032185) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |