| NPI | 1578053955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN WYATT Member 573-433-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2017011362) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2010036135) |
| 101YM0800X Counselor, Mental Health (Licence: MO 000281) | |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |