| NPI | 1639559685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ELAINE TADOKORO Clinical Director 816-977-3178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KS 3935) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2024-12-24 |