| NPI | 1740852730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN LEIGH MALONE Psychiatric Nurse Practitioner 314-766-7290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-07-11 |
| Last Update Date | 2021-07-11 |