| NPI | 1669617114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN REGINALD TRELOAR Psychotherapist 618-741-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2003017029) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |