| NPI | 1659625937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA E BRIDGEWATER Licensed Psychologist 417-549-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 1999140492) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2014-03-03 |