| NPI | 1831630896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MARIE LOB Owner 816-808-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2014032120) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |