| NPI | 1902258767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA HAWK Owner 573-616-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 101YP2500X) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 101Y00000X) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 101YA0400X) | |
| 101YM0800X Counselor, Mental Health (Licence: 101YM0800X) | |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2020-12-11 |