| NPI | 1659301562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GAFFORD Clinical Psychologist 314-275-7802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2001031420) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2004013906) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |