| NPI | 1952867749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANA HUBBARD Managing Partner 314-406-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-02-16 |
| Last Update Date | 2019-02-16 |