| NPI | 1770879421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ALLEN MAXVILLE Owner 573-864-9743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-06-21 |