| NPI | 1952470668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA M. LANTSBERGER Office Manager 314-881-4260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO M001687) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 01687) |
| 104100000X Social Worker (Licence: MO MO0004978) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2011-06-22 |