| NPI | 1871321257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SHELTON Administrator 314-727-0453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-07-25 |