| NPI | 1891190773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER D MARTIN Owner 314-602-3968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2012014744) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2012014744) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2014014744) | |
| 101YM0800X Counselor, Mental Health (Licence: MO 2014014744) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |