| NPI | 1639353915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND WILSON OBRIEN President 816-746-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MO py 012349) |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2007-12-22 |