| NPI | 1912250721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE C. HARRISON Executive Director 314-729-4667 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YP2500X Counselor, Professional | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |