| NPI | 1952727174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNNE SHASHEK Owner/Manager 636-248-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2002010266) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2025-03-04 |