| NPI | 1669803540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS SMITH Director 573-271-2008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2009023490) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2025-01-13 |