| NPI | 1912067398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATILDE MASSANA STONE Owner 573-335-0570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 000686) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 000746) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.007334) | |
| 1041C0700X Social Worker, Clinical (Licence: FL 0005083) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.006232) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW 5084) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |