| NPI | 1841810025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA D. BUSH Nurse Practitioner/Provider 314-296-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-05-06 |