| NPI | 1912885419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA T MALONE Managing Member/Owner 314-952-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |