| NPI | 1720576663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW ROBERTS REILLY MENATTI Director 314-833-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MO 2017002021) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MO 2017002021) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: MO 2017002021) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2023-12-12 |