| NPI | 1760515498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS BENDER Managed Care Coordinator 314-962-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |