| NPI | 1578801007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MCHENRY Director 618-251-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |