| NPI | 1932575628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI E. SEIDEL Owner/Counselor 636-686-0706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MO 2014000741) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |