| NPI | 1679766307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLINDA MAE SULLIVAN Clinical Psychologist 573-528-7569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2004024741) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |