| NPI | 1932374592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN AVON TANN Owner 314-644-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO SW003913) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2012-04-17 |