| NPI | 1669824025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND T FEZZI Psychotherapist 314-894-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 000775) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |